Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 06759 | Date 25/10/2019 |
| Token No | SM/19-20/12411 25/10/2019 | Serial | 027 Last Visit: 25/10/2019 |
| Patient Name | Miss RAFIKA KHATUN | Contact No | 7044879699 |
| Address | 9 MIYA JAN DARJI LANE , SERAMPORE MALLICK PARA | Age | 9 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 21 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||