Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05647 | Date 02/07/2019 |
| Token No | SM/19-20/5772 02/07/2019 | Serial | 062 Last Visit: 02/07/2019 |
| Patient Name | Miss ARIFA KHATUN | Contact No | 9007712385 |
| Address | 20 CHATRA MUSALMAN PARA | Age | 14 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 31 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||