Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 12451 | Date 11/09/2023 |
| Token No | SM/22-23/24306 11/09/2023 | Serial | 029 Last Visit: 11/06/2025 |
| Patient Name | Miss NAZMA KHATUN | Contact No | |
| Address | 48 CHATRA MUSALMAN PARA SERAMPORE | Age | 11 Years,3 Months,15 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 19.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||