Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 10428 | Date 16/12/2021 |
| Token No | SM/21-22/7821 16/12/2021 | Serial | 014 Last Visit: 17/12/2021 |
| Patient Name | Mrs. NASIFA KHATUN | Contact No | 7449960282 |
| Address | 13,CHATRA MUSHALMAN PARA SERAMPORE | Age | 18 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||