Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 05305 | Date 31/05/2019 |
| Token No | SM/19-20/9468 30/08/2019 | Serial | 040 Last Visit: 25/05/2022 |
| Patient Name | Miss RUKSANA KHATUN | Contact No | 8017230758 |
| Address | 34 MUSALMAN PRA LANE SERAMPORE(M) | Age | 14 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 27 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||