Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 10082 | Date 14/09/2021 |
| Token No | SM/21-22/5075 14/09/2021 | Serial | 011 Last Visit: 27/09/2021 |
| Patient Name | Mrs. SHAGUFTA YASMIN | Contact No | 9062151633 |
| Address | CHAMPDANI | Age | 24 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||