Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05030 | Date 07/05/2019 |
| Token No | SM/19-20/2834 15/05/2019 | Serial | 074 Last Visit: 15/05/2019 |
| Patient Name | Miss SAIMA KHATUN | Contact No | 9088030702 |
| Address | CHATRA MUASLMAN PARA | Age | 18 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 33 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||