Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 07401 | Date 22/01/2020 |
| Token No | SM/19-20/17055 22/01/2020 | Serial | 036 Last Visit: 22/01/2020 |
| Patient Name | Mrs. NASRINA KHATOON | Contact No | 8444979212 |
| Address | 7 ARBINDA SARANI SERAMPORE | Age | 18 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 61 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||