Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 10179 | Date 05/10/2021 |
| Token No | SM/21-22/5791 05/10/2021 | Serial | 042 Last Visit: 05/10/2021 |
| Patient Name | Mrs. NAZMA KHATUN | Contact No | 9088826738 |
| Address | 44,N.N ROY STREET SERAMPORE | Age | 50 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||