Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 08790 | Date 28/09/2020 |
| Token No | SM/20-21/26779 17/10/2020 | Serial | 010 Last Visit: 03/12/2020 |
| Patient Name | Mrs. MARIYA KHATOON (SK MARIYA BIBI) | Contact No | 7890182818 |
| Address | D/O IMAMUDDIN, 42 PANCHU GOPAL BHADURI SARANI, TINBAZAR, SERAMPORE, HOOGHLY, 712201 | Age | 36 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||