Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 10740 | Date 02/03/2022 |
| Token No | SM/21-22/11008 23/03/2022 | Serial | 014 Last Visit: 24/09/2024 |
| Patient Name | Miss GOLAPSA KHATUN | Contact No | |
| Address | 25/C KANAI DEOWAN TALA SERAMPORE | Age | 18 Years,1 Months,30 Days Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||