Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 10822 | Date 21/03/2022 |
| Token No | SM/21-22/10942 21/03/2022 | Serial | 055 Last Visit: 21/03/2022 |
| Patient Name | Miss NARGIS KHATUN | Contact No | 841051470 |
| Address | 5/1 MUSALMAN PARA BYE LANE | Age | 13 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||