Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 04326 | Date 20/03/2019 |
| Token No | SM/18-19/10966 20/03/2019 | Serial | 071 Last Visit: 25/03/2019 |
| Patient Name | Mrs. SANJILA BANU | Contact No | 7278161258 |
| Address | 88E MIA JAN DARJI LINE MALLIK PARA SERAMPORE | Age | 38 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 110/74 mmHg | Weight | 71 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||