Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 09325 | Date 15/03/2021 |
| Token No | SM/20-21/30742 15/03/2021 | Serial | 054 Last Visit: 19/03/2021 |
| Patient Name | Mrs. AJMERI KHATUN | Contact No | 8583030779 |
| Address | 4 K.M BHATTACHARYA STREET | Age | 23 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||