Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 00046 | Date 02/08/2018 |
| Token No | SM/19-20/3286 23/05/2019 | Serial | 034 Last Visit: 19/10/2020 |
| Patient Name | Mrs. HASINA KHATUN | Contact No | 9230292662 |
| Address | CHATRA MUSALMAN PARA , BAIDYABATI(M) | Age | 32 yrs Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 85 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||