Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02077 | Date 22/11/2018 |
| Token No | SM/19-20/11028 24/09/2019 | Serial | 046 Last Visit: 24/09/2019 |
| Patient Name | Miss SELANA KHATUN | Contact No | 8697436527 |
| Address | CHATRA MUSALMAN PARA | Age | 17 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||