Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 08712 | Date 08/09/2020 |
| Token No | SM/19-20/25498 08/09/2020 | Serial | 012 Last Visit: 08/09/2020 |
| Patient Name | Mrs. SERIFA BIBI | Contact No | 9830317053 |
| Address | 10/A MUSALMAN PARA BYE LANE CHATRA SERAMPORE | Age | 65 yrs Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||