Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04938 | Date 27/04/2019 |
| Token No | SM/19-20/1785 27/04/2019 | Serial | 034 Last Visit: 27/04/2019 |
| Patient Name | Miss QURASHIN | Contact No | 9007274830 |
| Address | G T ROAD BOU BAZAR , BAIDYABTI(M) | Age | 6 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 15.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||