Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03962 | Date 02/03/2019 |
| Token No | SM/19-20/23552 30/06/2020 | Serial | 005 Last Visit: 02/03/2022 |
| Patient Name | Miss BARSHA KHATUN | Contact No | 9748770251 |
| Address | 4/A MUSALMAN PARA BEY LANE | Age | 15 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||