Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 09355 | Date 19/03/2021 |
| Token No | SM/21-22/613 20/04/2021 | Serial | 022 Last Visit: 18/09/2021 |
| Patient Name | Mrs. SHAHJAHAN KHATOON | Contact No | 9748284723 |
| Address | 24 PARSHI LANE SERAMPORE | Age | 20 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||