Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05530 | Date 22/06/2019 |
| Token No | SM/19-20/5119 22/06/2019 | Serial | 080 Last Visit: 22/06/2019 |
| Patient Name | Baby SAHANA KHATUN | Contact No | |
| Address | CHATRA MUSALMAN PARA | Age | 1.8 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||