Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03383 | Date 05/02/2019 |
| Token No | SM/18-19/8054 05/02/2019 | Serial | 045 Last Visit: 05/02/2019 |
| Patient Name | Miss AFSANA KHATUN | Contact No | 7890152684 |
| Address | 29/A CHATRAMUSALMAN PARA | Age | 8 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 23 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||