Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06927 | Date 20/11/2019 |
| Token No | SM/25-26/5389 29/08/2025 | Serial | 004 Last Visit: 29/08/2025 |
| Patient Name | Miss JAMILA KHATUN | Contact No | 7439100511 |
| Address | 21 CHATRA MUSALMAN PARA SERAMPORE | Age | 9 Years,4 Months,18 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 23.1 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||