Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 00279 | Date 09/08/2018 |
| Token No | SM/19-20/11519 07/10/2019 | Serial | 003 Last Visit: 27/11/2021 |
| Patient Name | Mrs. TABASUM KHATOON | Contact No | 9339742590 |
| Address | CHATRA MUSALMAN PARA , SERAMPORE | Age | 40 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||