Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 08353 | Date 15/06/2020 |
| Token No | SM/19-20/23672 02/07/2020 | Serial | 081 Last Visit: 26/03/2022 |
| Patient Name | Miss SAMIYA TAHIR | Contact No | 9903322367 |
| Address | 56, N.N RAY STREET SERAMPORE | Age | 16 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||