Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 04260 | Date 16/03/2019 |
| Token No | SM/18-19/10677 16/03/2019 | Serial | 059 Last Visit: 16/03/2019 |
| Patient Name | Mrs. SAKILA KHATUN | Contact No | 7450916105 |
| Address | 36/B MIAJAN DARJI LANE MALLIK PARA SERAMPORE | Age | 29 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 130/80 mmHg | Weight | 67 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||