Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01089 | Date 13/09/2018 |
| Token No | SM/19-20/3781 31/05/2019 | Serial | 025 Last Visit: 21/06/2019 |
| Patient Name | Baby SABANA KHATUN | Contact No | |
| Address | 20 CHATRA MUSALMAN PARA | Age | 2 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 10 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||