Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 02771 | Date 31/12/2018 |
| Token No | SM/19-20/6056 08/07/2019 | Serial | 029 Last Visit: 08/07/2019 |
| Patient Name | Baby SUHANA KHATUN | Contact No | 9830953893 |
| Address | 23/A MALLIK PARA ,MEYA DARJI LANE | Age | 5 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 16 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||