Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 00128 | Date 04/08/2018 |
| Token No | SM/19-20/20712 03/04/2020 | Serial | 043 Last Visit: 12/06/2025 |
| Patient Name | Mrs. BASIRUN NESSA | Contact No | 9674107583 |
| Address | CHATRA MUSALMAN PARA | Age | 34 Years,5 Months,10 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||