Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 07866 | Date 20/03/2020 |
| Token No | SM/21-22/3137 14/07/2021 | Serial | 010 Last Visit: 03/01/2023 |
| Patient Name | Miss TARANNUM KHATOON | Contact No | 6290206619 |
| Address | 88/D MIYAJAN DARJEE LANE | Age | 15 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||