Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04899 | Date 24/04/2019 |
| Token No | SM/19-20/7638 30/07/2019 | Serial | 087 Last Visit: 30/07/2019 |
| Patient Name | Miss SONIYA KHATUN | Contact No | 6289688121 |
| Address | 11 CHATRA MUSALMAN PARA | Age | 5.4 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 14 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||