Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 02712 | Date 28/12/2018 |
| Token No | SM/18-19/5884 28/12/2018 | Serial | 026 Last Visit: 28/12/2018 |
| Patient Name | Mrs. SUPHIYA BIBI | Contact No | |
| Address | SERAMPORE,MALLICK PARA | Age | 48 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||