Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05866 | Date 20/07/2019 |
| Token No | SM/19-20/6951 20/07/2019 | Serial | 054 Last Visit: 20/07/2019 |
| Patient Name | Miss REJINA KHATUN | Contact No | 9163922506 |
| Address | DEYARA,PALPARA | Age | 17 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||