Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 10092 | Date 16/09/2021 |
| Token No | SM/21-22/5156 16/09/2021 | Serial | 028 Last Visit: 16/09/2021 |
| Patient Name | Mrs. SHAMIMA KHATOON | Contact No | 9331579586 |
| Address | 15,BAZAR BYE LANE SERAMPORE | Age | 46 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||