Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05033 | Date 08/05/2019 |
| Token No | SM/21-22/6494 02/11/2021 | Serial | 009 Last Visit: 05/03/2025 |
| Patient Name | Mrs. ASIYA KHATUN | Contact No | 7890281370 |
| Address | CHATRA MUSALMAN PARA ROAD SERAMPORE | Age | 28 Years,6 Months,19 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||