Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03893 | Date 27/02/2019 |
| Token No | SM/18-19/9534 27/02/2019 | Serial | 023 Last Visit: 29/08/2019 |
| Patient Name | Miss JESMIN KHATUN | Contact No | 9903680612 |
| Address | 27/C CHATRA MUSALMAN PARA BYE LANE SERAMPORE | Age | 10 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 21 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||