Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04553 | Date 04/04/2019 |
| Token No | SM/19-20/271 04/04/2019 | Serial | 060 Last Visit: 04/04/2019 |
| Patient Name | Baby RUKSHA KHATUN | Contact No | 6294631464 |
| Address | 14 CHATRA NMUSALMAN PARA | Age | 2 Y 6 M Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 10 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||