Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 09558 | Date 30/04/2021 |
| Token No | SM/21-22/1029 30/04/2021 | Serial | 023 Last Visit: 18/10/2021 |
| Patient Name | Mrs. TINA KHATUN | Contact No | 6291526747 |
| Address | 47,CHATRA MUSALMAN PARA ROAD SERAMPORE | Age | 25 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||