Ticket for Outdoor Patient
| Ward No. 23 | U-PHC No. | Registration No. 04177 | Date 11/03/2019 |
| Token No | SM/18-19/10397 11/03/2019 | Serial | 106 Last Visit: 25/03/2021 |
| Patient Name | Miss SAHANAZ PARVIN GAZI | Contact No | 9748507037 |
| Address | 50/J KAJI PARA , BAIDYABATI(M) | Age | 17 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 34 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||