Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 08084 | Date 15/04/2020 |
| Token No | SM/19-20/21148 15/04/2020 | Serial | 032 Last Visit: 15/04/2020 |
| Patient Name | Mrs. AYESA KHATUN | Contact No | 6289712929 |
| Address | 92/87 KHAS BAGAN LANE BAIDYABATI M | Age | 42 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||