Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 08205 | Date 04/05/2020 |
| Token No | SM/19-20/22127 11/05/2020 | Serial | 035 Last Visit: 11/05/2020 |
| Patient Name | Mrs. SHAHEEN PARVEEN | Contact No | 9836248727 |
| Address | 5/A K.M. BHATTACHARYA STREET | Age | 25 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 48 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||