Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 09173 | Date 15/01/2021 |
| Token No | SM/20-21/29391 15/01/2021 | Serial | 024 Last Visit: 16/02/2022 |
| Patient Name | Mrs. AKTAR JAHAN RAHAMAN | Contact No | 8582880402 |
| Address | 18 KANAHAI DEWAN TALA BYE LANE SERAMPORE | Age | 75 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||