Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02425 | Date 08/12/2018 |
| Token No | SM/18-19/4944 08/12/2018 | Serial | 071 Last Visit: 08/12/2018 |
| Patient Name | Miss TAMANA KHATUN | Contact No | 9883044486 |
| Address | CHATRA MUSALMAN PARA | Age | 9 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 18 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||