Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04192 | Date 13/03/2019 |
| Token No | SM/20-21/30178 27/02/2021 | Serial | 025 Last Visit: 29/10/2021 |
| Patient Name | Miss SANJIDA KHATUN | Contact No | 6291852758 |
| Address | CHATRA MUSALMAN PARA | Age | 12 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||