Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 00453 | Date 14/08/2018 |
| Token No | SM/19-20/16422 09/01/2020 | Serial | 023 Last Visit: 09/01/2020 |
| Patient Name | Miss NARGIS KHATUN | Contact No | 9330631789 |
| Address | 5A MUSALMAN PARA, CHATRA | Age | 10.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 28 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||