Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04608 | Date 08/04/2019 |
| Token No | SM/20-21/27196 05/11/2020 | Serial | 057 Last Visit: 05/11/2020 |
| Patient Name | Miss ASMA KHATUN | Contact No | 7890481284 |
| Address | 21 MUSALMAN PARA BYE LANE CHATRA SERAMPORE | Age | 10 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||