Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01758 | Date 29/10/2018 |
| Token No | SM/21-22/3295 19/07/2021 | Serial | 013 Last Visit: 23/09/2025 |
| Patient Name | Miss YASMIN KHATUN | Contact No | 8697619357 |
| Address | 13, CHATRA MUSALMAN PARA | Age | 10 Years,8 Months,22 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||