Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05045 | Date 08/05/2019 |
| Token No | SM/19-20/2389 08/05/2019 | Serial | 080 Last Visit: 08/05/2019 |
| Patient Name | Miss AFSANA KHATUN | Contact No | 9748770281 |
| Address | 4/A CHATRA MUSALMAN PARA | Age | 13 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 35 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||