Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 03563 | Date 13/02/2019 |
| Token No | SM/18-19/8619 13/02/2019 | Serial | 086 Last Visit: 23/02/2019 |
| Patient Name | Miss ASIHYANA KHATUN | Contact No | 9903793963 |
| Address | 63 N N ROY STREET | Age | 17 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 36 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||