Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 08800 | Date 30/09/2020 |
| Token No | SM/20-21/26155 30/09/2020 | Serial | 009 Last Visit: 30/09/2020 |
| Patient Name | Mrs. NASIMA KHATOON | Contact No | 8240901437 |
| Address | 19 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 | |||