Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01757 | Date 29/10/2018 |
| Token No | SM/21-22/3239 16/07/2021 | Serial | 025 Last Visit: 16/07/2021 |
| Patient Name | Miss SOHANA KHATUN | Contact No | 7686829852 |
| Address | 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 | |||