Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05135 | Date 16/05/2019 |
| Token No | SM/21-22/1105 03/05/2021 | Serial | 053 Last Visit: 27/08/2021 |
| Patient Name | Miss RABINA KHATUN | Contact No | 8017230758 |
| Address | MUSHALMAN PARA SERAMPORE | Age | 14 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||