Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 08746 | Date 15/09/2020 |
| Token No | SM/20-21/25725 15/09/2020 | Serial | 050 Last Visit: 15/09/2020 |
| Patient Name | Mrs. REHMAT NESA | Contact No | |
| Address | 21 MUSALMAN PARA LANE SERAMPORE | Age | 28 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||