Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04420 | Date 27/03/2019 |
| Token No | SM/19-20/8274 09/08/2019 | Serial | 081 Last Visit: 05/02/2020 |
| Patient Name | Miss SANIYA KHATUN | Contact No | 9831236433 |
| Address | 1, CHATRA MUSALMAN PARA | Age | 11 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 28 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||