Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 07963 | Date 30/03/2020 |
| Token No | SM/19-20/20478 30/03/2020 | Serial | 029 Last Visit: 26/06/2025 |
| Patient Name | Miss RABINA KHATUN | Contact No | 7890084199 |
| Address | 5 ARABINDA SARANI CHATRA SERAMPORE | Age | 15 Years,10 Months,8 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||