Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02507 | Date 13/12/2018 |
| Token No | SM/18-19/7910 04/02/2019 | Serial | 006 Last Visit: 07/08/2019 |
| Patient Name | Miss JINNAT NAJNIN | Contact No | 7044682962 |
| Address | 39 CHATRA MUSALMAN PARA | Age | 9 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 29 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||