Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04051 | Date 06/03/2019 |
| Token No | SM/18-19/9996 06/03/2019 | Serial | 086 Last Visit: 06/03/2019 |
| Patient Name | Miss BARSHA KHATUN | Contact No | 9903710083 |
| Address | CHATRA KUMOR PARA | Age | 12 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 35 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||