Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03477 | Date 09/02/2019 |
| Token No | SM/18-19/8360 09/02/2019 | Serial | 005 Last Visit: 11/11/2019 |
| Patient Name | Mrs. MARJINA BIBI | Contact No | 7890402307 |
| Address | 53 CHATRA MUSALMAN PARA, SERAMPORE | Age | 70 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 126/80 mmHg | Weight | 43 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||