Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 09761 | Date 28/06/2021 |
| Token No | SM/21-22/2631 28/06/2021 | Serial | 024 Last Visit: 28/06/2021 |
| Patient Name | Miss RUBINA BANO | Contact No | 9051683013 |
| Address | 56 N.N ROY STREET SERAMPORE | Age | 23 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||