Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02916 | Date 09/01/2019 |
| Token No | SM/18-19/6537 09/01/2019 | Serial | 026 Last Visit: 09/01/2019 |
| Patient Name | Baby RAJIYA SULTANA | Contact No | 9874158416 |
| Address | CHATRA ,BOU BAZAR | Age | 3 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 10 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||