Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 02597 | Date 19/12/2018 |
| Token No | SM/18-19/5481 19/12/2018 | Serial | 045 Last Visit: 19/12/2018 |
| Patient Name | Baby NUSRAT KHATUN | Contact No | 9836788739 |
| Address | 34 , MUSALMAN PARA LANE | Age | 1 Y 6 M Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||