Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03349 | Date 04/02/2019 |
| Token No | SM/18-19/7955 04/02/2019 | Serial | 051 Last Visit: 17/10/2019 |
| Patient Name | Miss SARIFA KHATUN | Contact No | 8017387597 |
| Address | 35 CHATRA MUSALMAN PARA | Age | 12 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 34 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||