Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 05376 | Date 10/06/2019 |
| Token No | SM/19-20/4309 10/06/2019 | Serial | 091 Last Visit: 10/06/2019 |
| Patient Name | Miss JAHEDA KHATUN | Contact No | 8961591125 |
| Address | KHANDAKAR PARA FAKIR PARA SHEORAPHULI | Age | 20 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||