Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 09559 | Date 30/04/2021 |
| Token No | SM/21-22/3304 19/07/2021 | Serial | 022 Last Visit: 01/08/2025 |
| Patient Name | Mrs. MARJINA BIBI | Contact No | 8017353323 |
| Address | MUSHALMAN PARA CHATRA SERAMPORE | Age | 26 Years,7 Months,29 Days Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||