Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04464 | Date 29/03/2019 |
| Token No | SM/18-19/11532 29/03/2019 | Serial | 040 Last Visit: 04/04/2019 |
| Patient Name | Mrs. ASMILA BIBI | Contact No | 7890681377 |
| Address | 21A CHATRA KUMAR PARA SERAMPORE | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||