Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03408 | Date 06/02/2019 |
| Token No | SM/18-19/8143 06/02/2019 | Serial | 037 Last Visit: 28/02/2019 |
| Patient Name | Miss MUSKAN KHATUN | Contact No | 9143882680 |
| Address | 40CHATRA MUSALMAN PARA | Age | 11 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 69 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||