Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01784 | Date 30/10/2018 |
| Token No | SM/21-22/5326 22/09/2021 | Serial | 002 Last Visit: 08/12/2025 |
| Patient Name | Mrs. ROSENA KHATUN | Contact No | 9232501856 |
| Address | CHATRA MUSALMAN PARA SERAMPORE | Age | 50 Years,6 Months,16 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||