Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05649 | Date 02/07/2019 |
| Token No | SM/19-20/5775 02/07/2019 | Serial | 065 Last Visit: 02/07/2019 |
| Patient Name | Baby RAFISA KHATUN | Contact No | 8697000597 |
| Address | CHATRA MUSALMANPARA | Age | 1.1 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||