Ticket for Outdoor Patient
| Ward No. 21 | U-PHC No. | Registration No. 04665 | Date 11/04/2019 |
| Token No | SM/19-20/715 11/04/2019 | Serial | 022 Last Visit: 11/04/2019 |
| Patient Name | Miss MABUDA KHATUN | Contact No | 8777394055 |
| Address | 1/A CHILLEKHALA ROAD ,MALLICK PARA | Age | 21 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 120/80 mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||