Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01692 | Date 26/10/2018 |
| Token No | SM/18-19/5619 21/12/2018 | Serial | 069 Last Visit: 09/07/2021 |
| Patient Name | Mrs. AZIZA KHATUN | Contact No | 7022744302 |
| Address | 19 CHATRA MUSALMAN PARA, SERAMPORE | Age | 21 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||