Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 09845 | Date 15/07/2021 |
| Token No | SM/21-22/3183 15/07/2021 | Serial | 013 Last Visit: 15/07/2021 |
| Patient Name | Miss AFIFA KHATUN | Contact No | 9477030569 |
| Address | BURUBIBI TALA LANE, | Age | 9 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||