Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03920 | Date 28/02/2019 |
| Token No | SM/20-21/26741 16/10/2020 | Serial | 018 Last Visit: 19/01/2023 |
| Patient Name | Miss NILUFA YEASHMIN | Contact No | 8017565445 |
| Address | 28 NO C CHATRA MUSALMAN PRA BYE LANE SERAMPORE | Age | 16 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||