Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 07675 | Date 29/02/2020 |
| Token No | SM/19-20/19064 04/03/2020 | Serial | 038 Last Visit: 03/08/2020 |
| Patient Name | Mrs. PUJA KHATUN | Contact No | 9330637006 |
| Address | 5 A/1 CHATRA MUSALMAN PARA BYE LANE | Age | 18 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 48 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||