Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04157 | Date 11/03/2019 |
| Token No | SM/18-19/10351 11/03/2019 | Serial | 060 Last Visit: 11/03/2019 |
| Patient Name | Mrs. MAHEJAN BIBI | Contact No | 7044696224 |
| Address | 26 MALLIK PARA SERAMPORE | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||