Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04275 | Date 18/03/2019 |
| Token No | SM/18-19/10737 18/03/2019 | Serial | 036 Last Visit: 01/06/2020 |
| Patient Name | Mrs. MUMENA BIBI | Contact No | 9088594650 |
| Address | 33 CHATRA MUSALMAN PARA SERAMPORE (M) | Age | 34 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||