Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 01367 | Date 27/09/2018 |
| Token No | SM/18-19/2129 27/09/2018 | Serial | 010 Last Visit: 27/09/2018 |
| Patient Name | Mrs. SABINA BEGAM | Contact No | |
| Address | 16, T.C GOSWAMI STREET SERAMPORE | Age | 56 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 150/100 mmHg | Weight | 47 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||