Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05912 | Date 23/07/2019 |
| Token No | SM/19-20/7144 23/07/2019 | Serial | 082 Last Visit: 23/07/2019 |
| Patient Name | Miss ROSHAR KHATUN | Contact No | |
| Address | BARA BELUR KAL TALA | Age | 12 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||