Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 02413 | Date 08/12/2018 |
| Token No | SM/18-19/5010 10/12/2018 | Serial | 058 Last Visit: 10/12/2018 |
| Patient Name | Mrs. REHANA KHATUN | Contact No | 8961623605 |
| Address | SILBAGAN T. C GOSWAMI STREET | Age | 43 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 78 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||