Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01375 | Date 27/09/2018 |
| Token No | SM/18-19/2141 27/09/2018 | Serial | 022 Last Visit: 17/12/2022 |
| Patient Name | Miss NOORE SHABA KHATUN | Contact No | 6291658495 |
| Address | 29B CHATRA MUSALMAN PARA BYE LANE SERAMPORE | Age | 9 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 17 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||