Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02984 | Date 14/01/2019 |
| Token No | SM/19-20/12804 06/11/2019 | Serial | 057 Last Visit: 06/11/2019 |
| Patient Name | Miss NAPISA KHATUN | Contact No | 8126197011 |
| Address | CHATRA BOU BAJAR , BAIDYABATI (M) | Age | 6 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 19 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||