Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03446 | Date 07/02/2019 |
| Token No | SM/18-19/8262 07/02/2019 | Serial | 089 Last Visit: 16/03/2019 |
| Patient Name | Miss TABASUN KHATUN | Contact No | |
| Address | 21 CHATRA MUSALMAN PARA | Age | 13 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 31 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||