Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 04630 | Date 08/04/2019 |
| Token No | SM/19-20/529 08/04/2019 | Serial | 093 Last Visit: 08/04/2019 |
| Patient Name | Miss RESHMI KHATUN | Contact No | 6298104085 |
| Address | CHILEKHANA ROAD,MALLICK PARA | Age | 18 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||