Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01531 | Date 05/10/2018 |
| Token No | SM/18-19/9671 01/03/2019 | Serial | 046 Last Visit: 22/01/2020 |
| Patient Name | Mrs. SUMI KHATUN | Contact No | 7890481284 |
| Address | CHATRA MUSALMAN PARA | Age | 12 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 29 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||