Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 07474 | Date 04/02/2020 |
| Token No | SM/19-20/17618 04/02/2020 | Serial | 055 Last Visit: 13/07/2020 |
| Patient Name | Miss ROMA KHATOON | Contact No | 7044338915 |
| Address | 5/1 MUSALMAN PARA BYE LANE | Age | 11 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 36 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||