Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 11877 | Date 21/01/2023 |
| Token No | SM/22-23/19951 21/01/2023 | Serial | 036 Last Visit: 18/04/2023 |
| Patient Name | Mrs. MONIKA CHOWDHURY | Contact No | 9836371487 |
| Address | 9/1 BOROBAGAN LANE | Age | 24 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 61.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||