Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 05831 | Date 18/07/2019 |
| Token No | SM/19-20/6807 18/07/2019 | Serial | 082 Last Visit: 18/07/2019 |
| Patient Name | Miss TRISHA CHOWDHURY | Contact No | 8777260847 |
| Address | 9/E/8 BOROBAGAN LANE | Age | 12 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 44 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||