Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03943 | Date 02/03/2019 |
| Token No | SM/21-22/6613 08/11/2021 | Serial | 008 Last Visit: 19/07/2025 |
| Patient Name | Miss AFSANA KHATUN | Contact No | 7890402307 |
| Address | 53 CHATRA MUSALMAN PARA | Age | 15 Years,9 Months,28 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||