Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 04184 | Date 12/03/2019 |
| Token No | SM/18-19/10437 12/03/2019 | Serial | 028 Last Visit: 30/07/2022 |
| Patient Name | Miss KOYEL KHATUN | Contact No | 8017676928 |
| Address | SEORAPHULI BENGAL COAL LANE | Age | 10 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 25 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||