Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 10136 | Date 25/09/2021 |
| Token No | SM/21-22/5498 25/09/2021 | Serial | 037 Last Visit: 25/09/2021 |
| Patient Name | Mrs. ASMIRA BIBI | Contact No | 9123021060 |
| Address | 26/A MIYAJAN DARJI LANE SERAMPORE | Age | 28 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||