Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04609 | Date 08/04/2019 |
| Token No | SM/19-20/2173 04/05/2019 | Serial | 033 Last Visit: 22/08/2019 |
| Patient Name | Baby YEASMIN KHATUN | Contact No | 7890481284 |
| Address | 11 MUSALMAN PRA BYE LANE CHATRA | Age | 2.5 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 11 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||