Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 09521 | Date 22/04/2021 |
| Token No | SM/21-22/732 22/04/2021 | Serial | 067 Last Visit: 22/04/2021 |
| Patient Name | Miss TASLIMA PARVIN | Contact No | 6289153853 |
| Address | 11/A T.C GOSWAMI STREET SERAMPORE | Age | 15 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||