Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03672 | Date 18/02/2019 |
| Token No | SM/19-20/16747 16/01/2020 | Serial | 026 Last Visit: 16/01/2020 |
| Patient Name | Miss SELIMA KHATUN | Contact No | 8017271527 |
| Address | CHATRA MUSALMAN PARA | Age | 15 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 34 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||