Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 07470 | Date 04/02/2020 |
| Token No | SM/19-20/21474 23/04/2020 | Serial | 021 Last Visit: 23/04/2020 |
| Patient Name | Mrs. SARUFA KHATUN | Contact No | 9883048139 |
| Address | 31/A CHATRA MUSALMAN PARA | Age | 19 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||