Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 10339 | Date 26/11/2021 |
| Token No | SM/21-22/7200 26/11/2021 | Serial | 021 Last Visit: 26/11/2021 |
| Patient Name | Miss BARSHAT KHATOON | Contact No | 7439357813 |
| Address | 19,MUSHALMAN PARA BYE LANE SERAMPORE | Age | 16 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||