Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 09689 | Date 08/06/2021 |
| Token No | SM/21-22/2033 08/06/2021 | Serial | 035 Last Visit: 11/06/2021 |
| Patient Name | Mrs. FORIDA BEGAM | Contact No | 8981433083 |
| Address | 3B MUSALMAN PARA,SHEORAPHULY. | Age | 38 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||