Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 05763 | Date 13/07/2019 |
| Token No | SM/19-20/6446 13/07/2019 | Serial | 110 Last Visit: 13/07/2019 |
| Patient Name | Miss JUBEDA KHATUN | Contact No | 6291852758 |
| Address | CHATRA ARABINDA SARANI,BAIDYABATI(M) | Age | 14 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 25 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||