Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02985 | Date 14/01/2019 |
| Token No | SM/18-19/6743 14/01/2019 | Serial | 034 Last Visit: 30/10/2021 |
| Patient Name | Miss JULEKHA KHATUN | Contact No | |
| Address | CHATRA BOU BAJAR | Age | 12 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 41 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||