Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03593 | Date 15/02/2019 |
| Token No | SM/18-19/8734 15/02/2019 | Serial | 022 Last Visit: 15/02/2019 |
| Patient Name | Miss INSURA KHATUN | Contact No | |
| Address | 9 CHATRA ,AROBINDA SWARANI | Age | 12 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 24 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||