Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 09697 | Date 09/06/2021 |
| Token No | SM/21-22/2071 09/06/2021 | Serial | 036 Last Visit: 01/09/2021 |
| Patient Name | Mrs. FATEMA KHATUN | Contact No | 9062360109 |
| Address | 17/B KUMAR PARA LANE CHATRA SERAMPORE | Age | 23 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||