Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03648 | Date 18/02/2019 |
| Token No | SM/18-19/8892 18/02/2019 | Serial | 065 Last Visit: 18/02/2019 |
| Patient Name | Miss AFINA KHATUN | Contact No | 9748303030 |
| Address | CHATRA MUSALMAN PARA | Age | 15 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 44 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||