Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04448 | Date 28/03/2019 |
| Token No | SM/18-19/11469 28/03/2019 | Serial | 071 Last Visit: 28/03/2019 |
| Patient Name | Mrs. FULTAJ BIBI | Contact No | 9051914659 |
| Address | 131 CHATRA A.P GHOSH ROAD SERAMPORE | Age | 21 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 61 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||