Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 08789 | Date 28/09/2020 |
| Token No | SM/20-21/26087 28/09/2020 | Serial | 022 Last Visit: 28/09/2020 |
| Patient Name | Mrs. SARBANI BIBI | Contact No | 6290608104 |
| Address | 50/A CHATRA MUSALMAN PARA SERAMPORE | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||