Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 09322 | Date 15/03/2021 |
| Token No | SM/21-22/1027 30/04/2021 | Serial | 021 Last Visit: 30/04/2021 |
| Patient Name | Mrs. SARFUN NISHA | Contact No | 8013252565 |
| Address | 10 KANAI DEWAN TALA, | Age | 18 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||