Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01200 | Date 18/09/2018 |
| Token No | SM/19-20/10913 23/09/2019 | Serial | 040 Last Visit: 19/12/2022 |
| Patient Name | Mrs. AFRINA KHATOON | Contact No | 9903525847 |
| Address | 1 CHATRA MUSALMAN PARA, SERAMPORE | Age | 18 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||