Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 09800 | Date 06/07/2021 |
| Token No | SM/21-22/2905 06/07/2021 | Serial | 035 Last Visit: 07/04/2025 |
| Patient Name | Mrs. KANEEZ AISHA | Contact No | 9073311180 |
| Address | 18/16, DR. NURI BYE LANE SERAMPORE | Age | 33 Years,10 Months,28 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||