Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 09352 | Date 19/03/2021 |
| Token No | SM/20-21/30918 19/03/2021 | Serial | 027 Last Visit: 19/03/2021 |
| Patient Name | Mrs. ASHMA KHATOON | Contact No | 9123851481 |
| Address | 16/B RABINDRA BHAWAN ROAD | Age | 28 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||