Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 05407 | Date 13/06/2019 |
| Token No | SM/19-20/4470 13/06/2019 | Serial | 025 Last Visit: 13/06/2019 |
| Patient Name | Miss MEHJABIN KHATUN | Contact No | 8584943836 |
| Address | 15 BAJAR BYE LANE TINBAJAR | Age | 20 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 57 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||