Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02069 | Date 22/11/2018 |
| Token No | SM/18-19/9371 23/02/2019 | Serial | 057 Last Visit: 07/08/2019 |
| Patient Name | Miss MAISUNA ISLAM | Contact No | 9062747058 |
| Address | 39, MUSALMAN PARA ROAD | Age | 8 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 21 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||