Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 10397 | Date 09/12/2021 |
| Token No | SM/21-22/7601 09/12/2021 | Serial | 016 Last Visit: 24/05/2022 |
| Patient Name | Mrs. ROZY KHATUN | Contact No | 8603955858 |
| Address | KANAI DEWAN TALLA LANE SERAMPORE | Age | 18 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||