Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 08625 | Date 04/08/2020 |
| Token No | SM/19-20/24719 04/08/2020 | Serial | 029 Last Visit: 04/08/2020 |
| Patient Name | Miss JULEKHA KHATUN | Contact No | 9088173247 |
| Address | 17/A CHATRA MUSALMAN PARA SERAMPORE | Age | 11 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||