Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 08589 | Date 27/07/2020 |
| Token No | SM/19-20/24790 06/08/2020 | Serial | 065 Last Visit: 16/07/2022 |
| Patient Name | Miss ASURA KHATUN | Contact No | 7449983889 |
| Address | 4/A MUSALMAN PARA BYE LANE SERAMPORE | Age | 15 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||