Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 00452 | Date 14/08/2018 |
| Token No | SM/19-20/16748 16/01/2020 | Serial | 027 Last Visit: 16/01/2020 |
| Patient Name | Miss HALIMA KHATUN | Contact No | 9874233637 |
| Address | 5/A CHATRA MUSALMAN PARA | Age | 12 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 41 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||