Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 08446 | Date 29/06/2020 |
| Token No | SM/19-20/23518 29/06/2020 | Serial | 026 Last Visit: 29/06/2020 |
| Patient Name | Baby SULTANA KHATOON | Contact No | |
| Address | 36/A MUSALMAN PARA BYE LANE | Age | 4 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||