Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02853 | Date 07/01/2019 |
| Token No | SM/18-19/6371 07/01/2019 | Serial | 025 Last Visit: 19/01/2019 |
| Patient Name | Miss REJINA KHATUN | Contact No | 9163922508 |
| Address | DIARA , SINGUR(M) | Age | 16 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 41 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||