Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 09344 | Date 19/03/2021 |
| Token No | SM/21-22/624 20/04/2021 | Serial | 033 Last Visit: 06/07/2021 |
| Patient Name | Mrs. SHAMA KHATOON | Contact No | 9681140462 |
| Address | 5 NO PARSSIN LANE SILBAGAN SERAMPORE | Age | 28 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||