Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02270 | Date 01/12/2018 |
| Token No | SM/18-19/4943 08/12/2018 | Serial | 070 Last Visit: 08/07/2021 |
| Patient Name | Mrs. HASINA BIBI | Contact No | 9883044486 |
| Address | 21 MUSHAL MAN PARA SERAMPORE | Age | 28 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 51 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||