Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02716 | Date 28/12/2018 |
| Token No | SM/18-19/5895 28/12/2018 | Serial | 037 Last Visit: 28/12/2018 |
| Patient Name | Mrs. RUKSANA KHATUN | Contact No | 8240196073 |
| Address | 34 CHATRA MUSALMAN PARA | Age | 19 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 57 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||