Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04264 | Date 16/03/2019 |
| Token No | SM/19-20/25139 25/08/2020 | Serial | 019 Last Visit: 06/07/2022 |
| Patient Name | Miss SURIA KHATUN | Contact No | 7449983889 |
| Address | 4/A CHATRA MUSALMAN PARA SERAMPORE | Age | 13 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||