Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01113 | Date 28/09/2018 |
| Token No | SM/18-19/1481 28/09/2018 | Serial | 030 |
| Patient Name | Miss JAHANARA KHATUN | Contact No | |
| Address | Age | 21 Female | |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||