Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 10149 | Date 28/09/2021 |
| Token No | SM/21-22/5573 28/09/2021 | Serial | 005 Last Visit: 28/09/2021 |
| Patient Name | Mrs. SABIYA BIBI | Contact No | 6289256409 |
| Address | 13 CHATRA BARIN GHOSH LANE | Age | 27 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||