Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 05730 | Date 11/07/2019 |
| Token No | SM/19-20/6268 11/07/2019 | Serial | 018 Last Visit: 11/07/2019 |
| Patient Name | Mrs. TASLIMA BIBI | Contact No | 8478953945 |
| Address | 28 CHILEKHALA ROAD,MALLICK PARA | Age | 32 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 70 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||