Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 05074 | Date 11/05/2019 |
| Token No | SM/19-20/2580 11/05/2019 | Serial | 068 Last Visit: 11/05/2019 |
| Patient Name | Mrs. RUKSANA KHATUN | Contact No | 7890599035 |
| Address | TELIPARA, BAIDYABATI M | Age | 34 Y Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||