Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02144 | Date 26/11/2018 |
| Token No | SM/18-19/7704 31/01/2019 | Serial | 078 Last Visit: 23/09/2025 |
| Patient Name | Miss ROSHANI PARVEEN | Contact No | 9073311180 |
| Address | 13, CHATRA MUSALMAN PARA | Age | 13 Years,8 Months,22 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 17 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||