Ticket for Outdoor Patient
| Ward No. 21 | U-PHC No. | Registration No. 10799 | Date 14/03/2022 |
| Token No | SM/21-22/10773 14/03/2022 | Serial | 032 Last Visit: 14/03/2022 |
| Patient Name | Miss BASIRA KHATUN | Contact No | 6291336680 |
| Address | 21 NOMUSALMAN PARA | Age | 6YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 20 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||