Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 11261 | Date 13/07/2022 |
| Token No | SM/22-23/14546 13/07/2022 | Serial | 008 Last Visit: 13/07/2022 |
| Patient Name | Mrs. ASLIMA BIBI | Contact No | |
| Address | 21 KANAI DEWAN TALA LANE SERAMPORE | Age | 65 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 47 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||