Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 10121 | Date 23/09/2021 |
| Token No | SM/21-22/5396 23/09/2021 | Serial | 041 Last Visit: 23/09/2021 |
| Patient Name | Mrs. NURJAHAN KHATOON | Contact No | 9163887358 |
| Address | CHATRA ARABINDA SARANI | Age | 19 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||