Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01712 | Date 27/10/2018 |
| Token No | SM/18-19/3003 27/10/2018 | Serial | 052 Last Visit: 01/02/2020 |
| Patient Name | Miss NAJIMA KHATUN | Contact No | 7450965951 |
| Address | 18/1 CHATRA MUSALMAN PARA BEY LANE CHATRA SERAMPORE | Age | 18 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 44 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||