Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03869 | Date 26/02/2019 |
| Token No | SM/18-19/9476 26/02/2019 | Serial | 029 Last Visit: 13/02/2020 |
| Patient Name | Mrs. ROJANA KHATUN | Contact No | 6289202025 |
| Address | 21 MUSALMAN PARA BYE LANE SERAMPORE | Age | 18 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 44 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||