Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 08812 | Date 03/10/2020 |
| Token No | SM/20-21/26839 19/10/2020 | Serial | 050 Last Visit: 19/10/2020 |
| Patient Name | Miss MOHENA KHATUN | Contact No | 8697954706 |
| Address | 19/A CHATRA BOU BAZAR , BAIDYABATI(M) | Age | 20 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||