Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 09353 | Date 19/03/2021 |
| Token No | SM/20-21/30922 19/03/2021 | Serial | 031 Last Visit: 06/07/2021 |
| Patient Name | Mrs. SARMILA KHATOON | Contact No | 9875370885 |
| Address | 17 PARSHI LANE SERAMPORE | Age | 23 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||