Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 08401 | Date 22/06/2020 |
| Token No | SM/19-20/23300 22/06/2020 | Serial | 017 Last Visit: 23/08/2021 |
| Patient Name | Miss TAMANNA KHATOON | Contact No | 8240852522 |
| Address | 5 ARBINDA SARANI CHATRA SERAMPORE | Age | 10 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||