Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03370 | Date 05/02/2019 |
| Token No | SM/18-19/8019 05/02/2019 | Serial | 010 Last Visit: 05/02/2019 |
| Patient Name | Baby SAIBA KHATUN | Contact No | 8017028867 |
| Address | 41 CHATRA MUSALMAN PARA | Age | 1 Y 8 M Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 12 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||