Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03972 | Date 02/03/2019 |
| Token No | SM/18-19/9767 02/03/2019 | Serial | 086 Last Visit: 06/07/2022 |
| Patient Name | Miss HASINA KHATUN | Contact No | 9123385478 |
| Address | 8 ARBINDA SARANI LANE CHATRA SERAMPORE | Age | 18 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 41 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||