Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02754 | Date 31/12/2018 |
| Token No | SM/18-19/6023 31/12/2018 | Serial | 022 Last Visit: 31/12/2018 |
| Patient Name | Miss SHERIN KHATUN | Contact No | 9831236433 |
| Address | 1 CHATRA MUSALMAN PARA | Age | 14 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||