Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 08118 | Date 20/04/2020 |
| Token No | SM/19-20/21350 20/04/2020 | Serial | 025 Last Visit: 20/08/2025 |
| Patient Name | Mrs. HALIMA KHATUN | Contact No | 9007661449 |
| Address | 31/A CHATRA MUSALMAN PARA BYE LANE | Age | 27 Years,9 Months,16 Days Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||