Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 09631 | Date 21/05/2021 |
| Token No | SM/21-22/1594 21/05/2021 | Serial | 010 Last Visit: 21/05/2021 |
| Patient Name | Mrs. SAMIMA KHATUN | Contact No | |
| Address | CHATRA MUSHALMAN PARA SERAMPORE | Age | 30 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||