Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 08675 | Date 26/08/2020 |
| Token No | SM/19-20/25211 26/08/2020 | Serial | 021 Last Visit: 26/08/2020 |
| Patient Name | Miss SAHINA KHATOON | Contact No | 9874770573 |
| Address | 20 MUSALMAN PARA ROAD SERAMPORE | Age | 10 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||