Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 04193 | Date 13/03/2019 |
| Token No | SM/18-19/10970 20/03/2019 | Serial | 075 Last Visit: 08/04/2019 |
| Patient Name | Mrs. JAHRUL NESA | Contact No | 7278161258 |
| Address | 88 MIA JAN DARJI LINE MALLIK PARA SERAMPORE | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 120/80 mmHg | Weight | 66 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||