Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03706 | Date 19/02/2019 |
| Token No | SM/18-19/9963 06/03/2019 | Serial | 053 Last Visit: 06/03/2019 |
| Patient Name | Baby SALIMA KAHTUN | Contact No | |
| Address | 36/ACHATRA MUSALMAN PARA | Age | 3 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 12 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||