Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 10759 | Date 08/03/2022 |
| Token No | SM/21-22/10582 08/03/2022 | Serial | 007 Last Visit: 11/03/2024 |
| Patient Name | Miss AMENA KHATUN | Contact No | 8595302405 |
| Address | 20 KANAI DEOWAN TALA SERAMPORE (M) | Age | 10 Years,9 Months,15 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 24 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||