Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 09850 | Date 16/07/2021 |
| Token No | SM/21-22/3240 16/07/2021 | Serial | 026 Last Visit: 13/09/2021 |
| Patient Name | Mrs. HALIMA KHATUN | Contact No | 9875511447 |
| Address | CHAPDANI BAIDHYABATI | Age | 22 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||