Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 09364 | Date 19/03/2021 |
| Token No | SM/20-21/30953 19/03/2021 | Serial | 062 Last Visit: 20/03/2021 |
| Patient Name | Mrs. NASIBA KHATUN | Contact No | 6289874228 |
| Address | 16 T.C. GOSWAMI STREET | Age | 30 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||