Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 00238 | Date 08/08/2018 |
| Token No | SM/21-22/5354 22/09/2021 | Serial | 030 Last Visit: 04/07/2022 |
| Patient Name | Miss SAMRIN YASMIN | Contact No | 6291534758 |
| Address | 7/B CHATRA,MUSALMAN PARA | Age | 9 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||