Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06057 | Date 05/08/2019 |
| Token No | SM/19-20/7973 05/08/2019 | Serial | 112 Last Visit: 05/08/2019 |
| Patient Name | Miss SAFILA KHATUN | Contact No | 8420104775 |
| Address | CHATRA MUSALMAN PARA | Age | 15 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||