Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01318 | Date 25/09/2018 |
| Token No | SM/19-20/23752 04/07/2020 | Serial | 021 Last Visit: 04/07/2020 |
| Patient Name | Mrs. JESMIN KHATUN | Contact No | 7890681705 |
| Address | 4/A CHATRA MUSALMAN PARA SERAMPORE | Age | 20 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||