Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05797 | Date 16/07/2019 |
| Token No | SM/19-20/10785 20/09/2019 | Serial | 076 Last Visit: 28/04/2021 |
| Patient Name | Miss AMERA KHATUN | Contact No | 9875427846 |
| Address | 20, CHATRA MUSALMAN PARA | Age | 7 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||