Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 09744 | Date 23/06/2021 |
| Token No | SM/21-22/2496 23/06/2021 | Serial | 050 Last Visit: 23/06/2021 |
| Patient Name | Miss AFRIN KHATUN | Contact No | 6354184365 |
| Address | 19 SHEORAPHULY,CHATRA MUSALMAN PARA | Age | 6 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||