Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 10924 | Date 13/04/2022 |
| Token No | SM/22-23/14197 30/06/2022 | Serial | 032 Last Visit: 30/06/2022 |
| Patient Name | Miss ASMIN KHATUN | Contact No | 8617716366 |
| Address | 11 MUSALMANPARA BYE LANE CHATRA SERAMPORE | Age | 5YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 18 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||