Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01427 | Date 29/09/2018 |
| Token No | SM/18-19/11275 26/03/2019 | Serial | 068 Last Visit: 03/07/2025 |
| Patient Name | Miss GULABSA KHATUN | Contact No | 6290407438 |
| Address | 25/C CHATRA KANAI DEWAN TALA | Age | 18 Years,11 Months,8 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 29 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||