Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02743 | Date 29/12/2018 |
| Token No | SM/18-19/5994 29/12/2018 | Serial | 049 Last Visit: 29/12/2018 |
| Patient Name | Miss RIYA KHATUN | Contact No | 7890759202 |
| Address | 30A CHATRA MUSALMAN PARA | Age | 12 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 31 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||