Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04628 | Date 08/04/2019 |
| Token No | SM/19-20/525 08/04/2019 | Serial | 089 Last Visit: 08/04/2019 |
| Patient Name | Miss NAJNI KHATUN | Contact No | 8617274181 |
| Address | 21 CHATRA MUSALMAN PARA | Age | 7 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 20 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||