Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04043 | Date 06/03/2019 |
| Token No | SM/21-22/2442 22/06/2021 | Serial | 031 Last Visit: 22/06/2021 |
| Patient Name | Miss HALIMA KHATUN | Contact No | 6291491910 |
| Address | 5/A CHATRA MUSALMAN PARA | Age | 15 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||