Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01757 | Date 29/10/2018 |
| Token No | SM/19-20/2715 14/05/2019 | Serial | 029 Last Visit: 16/07/2021 |
| Patient Name | Miss SOHANA KHATUN | Contact No | 7686829852 |
| Address | CHATRA MUSALMAN PARA | Age | 15 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 32 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||