Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 08785 | Date 26/09/2020 |
| Token No | SM/20-21/29155 07/01/2021 | Serial | 049 Last Visit: 21/04/2021 |
| Patient Name | Miss JOHARA KHATUN | Contact No | 7479200445 |
| Address | 56 N N ROY STREET SERAMPORE | Age | 18 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||