Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04261 | Date 16/03/2019 |
| Token No | SM/18-19/10683 16/03/2019 | Serial | 065 Last Visit: 16/03/2019 |
| Patient Name | Mrs. MUSARAT BIBI | Contact No | 9874142203 |
| Address | 21 CHATRA MUSALMAN PARA SERAMPORE | Age | 24 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||