Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02825 | Date 04/01/2019 |
| Token No | SM/18-19/7825 02/02/2019 | Serial | 014 Last Visit: 02/02/2019 |
| Patient Name | Miss NAPISA KHATUN | Contact No | |
| Address | 9, CHATRA MUSALMAN PARA | Age | 13 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||