Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 01465 | Date 01/10/2018 |
| Token No | SM/21-22/6244 25/10/2021 | Serial | 066 Last Visit: 25/10/2021 |
| Patient Name | Miss AZIMA ZABI | Contact No | 968126531 |
| Address | 45, N.N ROY STREET SERAMPORE | Age | 14 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||