Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 04123 | Date 09/03/2019 |
| Token No | SM/18-19/10263 09/03/2019 | Serial | 054 Last Visit: 09/03/2019 |
| Patient Name | Miss SALMA KHATUN | Contact No | 9230292662 |
| Address | 17/E/2 CHAKA PARA SERAMPORE | Age | 22 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||