Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04347 | Date 23/03/2019 |
| Token No | SM/18-19/11461 28/03/2019 | Serial | 063 Last Visit: 28/03/2019 |
| Patient Name | Mrs. ASRINA BIBI | Contact No | 7449738066 |
| Address | CHATRA MUSALMAN PARA SERAMPORE | Age | 18 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 48 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||