Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 09105 | Date 28/12/2020 |
| Token No | SM/20-21/28842 28/12/2020 | Serial | 054 Last Visit: 05/01/2021 |
| Patient Name | Mrs. PARVIN KHATOON | Contact No | 8583948703 |
| Address | 18/1 CHATRA MUSALMANPARA SERAMPORE M | Age | 22 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||