Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 09560 | Date 30/04/2021 |
| Token No | SM/21-22/1031 30/04/2021 | Serial | 025 Last Visit: 10/06/2021 |
| Patient Name | Mrs. SALIMA BEGUM KHATOON | Contact No | 9230112359 |
| Address | MUSHALMAN PARA CHATRA SERAMPORE | Age | 33 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||