Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 05841 | Date 19/07/2019 |
| Token No | SM/19-20/12108 21/10/2019 | Serial | 005 Last Visit: 13/12/2023 |
| Patient Name | Miss SARMILA BHUIYA | Contact No | 7686830295 |
| Address | 31A BORO BAGAN SIBTALA | Age | 12 Years,3 Months,28 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||