Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01467 | Date 01/10/2018 |
| Token No | SM/18-19/6626 10/01/2019 | Serial | 053 Last Visit: 14/01/2019 |
| Patient Name | Miss AFSANA KHATUN | Contact No | 8444979212 |
| Address | 7, CHATRA ARBINDA SARANI | Age | 18 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 46 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||