Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 07641 | Date 27/02/2020 |
| Token No | SM/19-20/18848 28/02/2020 | Serial | 034 Last Visit: 28/02/2020 |
| Patient Name | Mrs. ALEA KHATUN | Contact No | 7044595390 |
| Address | 10 CHATRA MUSALMAN PARA SERAMPORE | Age | 19 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||