Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 03179 | Date 25/01/2019 |
| Token No | SM/18-19/8789 16/02/2019 | Serial | 013 Last Visit: 18/09/2019 |
| Patient Name | Mrs. SAKINA BIBI | Contact No | 9339989682 |
| Address | 4 ROY GHAT LANE SERAMPORE | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||