Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 00518 | Date 17/08/2018 |
| Token No | SM/18-19/591 17/08/2018 | Serial | 029 Last Visit: 27/12/2018 |
| Patient Name | Baby JAMELA KHATUN | Contact No | |
| Address | CHATRA MUSALMAN PARA | Age | 4 Years,4 Months,0 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 10 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||