Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03962 | Date 02/03/2019 |
| Token No | SM/18-19/9750 02/03/2019 | Serial | 069 Last Visit: 02/03/2022 |
| Patient Name | Miss BARSHA KHATUN | Contact No | 9748770251 |
| Address | 4/A MUSALMAN PARA BEY LANE | Age | 15 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 35 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||