Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 03354 | Date 04/02/2019 |
| Token No | SM/18-19/7968 04/02/2019 | Serial | 064 Last Visit: 16/02/2019 |
| Patient Name | Mrs. KOUSAR BIBI | Contact No | |
| Address | 18 SILBAGAN,SERAMPORE | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 59.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||