Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05329 | Date 03/06/2019 |
| Token No | SM/19-20/3938 03/06/2019 | Serial | 061 Last Visit: 03/06/2019 |
| Patient Name | Miss FARJIA KHATUN | Contact No | 8837509819 |
| Address | RAMCHANDRA PUR, DIARA | Age | 5.9 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 18 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||