Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 09491 | Date 19/04/2021 |
| Token No | SM/21-22/578 19/04/2021 | Serial | 045 Last Visit: 19/04/2021 |
| Patient Name | Miss RINA KHATUN | Contact No | 8444012446 |
| Address | 8,ARBINDA SARANI CHATRA SERAMPORE | Age | 16 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||