Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 06201 | Date 22/08/2019 |
| Token No | SM/19-20/9259 27/08/2019 | Serial | 067 Last Visit: 27/08/2019 |
| Patient Name | Mrs. SABANA KHATUN | Contact No | 6291662370 |
| Address | 64 A/B KAJIPARA DHAN MATH , BAIDYBATI(M) | Age | 22 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||