Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 10094 | Date 16/09/2021 |
| Token No | SM/21-22/5166 16/09/2021 | Serial | 038 Last Visit: 18/09/2021 |
| Patient Name | Miss TUHINA KHATUN | Contact No | 9330613343 |
| Address | 41 CHATRA MUSALMAN PARA, | Age | 15 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||