Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 10213 | Date 22/10/2021 |
| Token No | SM/21-22/6084 22/10/2021 | Serial | 015 Last Visit: 22/10/2021 |
| Patient Name | Mrs. AYESHA KHATUN | Contact No | 8274034801 |
| Address | 10,T.C GHOSWAMI STREET SERAMPORE | Age | 28 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||