Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04264 | Date 16/03/2019 |
| Token No | SM/18-19/10687 16/03/2019 | Serial | 069 Last Visit: 06/07/2022 |
| Patient Name | Miss SURIA KHATUN | Contact No | 7449983889 |
| Address | 4/A CHATRA MUSALMAN PARA SERAMPORE | Age | 13 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 27 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||