Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 10573 | Date 18/01/2022 |
| Token No | SM/21-22/9221 21/01/2022 | Serial | 029 Last Visit: 11/07/2025 |
| Patient Name | Mrs. SAWANA KHATUN | Contact No | 6289511765 |
| Address | 12 MUSALMAN PARA BYE LANE CHATRA SHEORAPHULI M | Age | 25 Years,6 Months,9 Days Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||