Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03942 | Date 01/03/2019 |
| Token No | SM/18-19/9681 01/03/2019 | Serial | 056 Last Visit: 01/03/2019 |
| Patient Name | Miss SABANA KHATUN | Contact No | 8013894235 |
| Address | CHATRA MUSALMAN PARA | Age | 14 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||