Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 09181 | Date 16/01/2021 |
| Token No | SM/21-22/3786 05/08/2021 | Serial | 018 Last Visit: 05/08/2021 |
| Patient Name | Mrs. KASIDA BIBI | Contact No | 9330577268 |
| Address | 21 MUSALMAN PARA LANE SERAMPORE | Age | 44 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||