Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 09163 | Date 13/01/2021 |
| Token No | SM/20-21/29306 13/01/2021 | Serial | 029 Last Visit: 13/01/2021 |
| Patient Name | Mrs. NAYEEMA KHATOON | Contact No | 9038275846 |
| Address | W/O MD FAROOQUE, 47/A/13, R.K. ROAD, RISHRA M, RISHRA, HOOGHLY, PIN-712248 | Age | 41 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||