Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 07290 | Date 07/01/2020 |
| Token No | SM/19-20/16308 07/01/2020 | Serial | 016 Last Visit: 07/01/2020 |
| Patient Name | Miss AYASA KHATUN | Contact No | 9073182883 |
| Address | 2/D CHILAKHANA ROAD SERAMPORE | Age | 16 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 43 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||