Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05545 | Date 24/06/2019 |
| Token No | SM/19-20/5208 24/06/2019 | Serial | 074 Last Visit: 15/10/2025 |
| Patient Name | Mrs. AJMIRA KHATUN | Contact No | |
| Address | 28/A CHATRA MUSALMAN PARA BYE LANE SERAMPORE | Age | 60 Years,9 Months,13 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 35 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||