Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02041 | Date 19/11/2018 |
| Token No | SM/22-23/19347 30/12/2022 | Serial | 002 Last Visit: 30/12/2022 |
| Patient Name | Miss SABANA KHATUN | Contact No | 8420973277 |
| Address | 21, CHATRA MUSALMAN PARA BY LANE | Age | 18 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 52.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||