Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06447 | Date 17/09/2019 |
| Token No | SM/19-20/10546 17/09/2019 | Serial | 037 Last Visit: 17/09/2019 |
| Patient Name | Mrs. KAJAL BIBI | Contact No | |
| Address | BARO BELU KAL TALA , PIYARAPUR SERAMPORE | Age | 38 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 57 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||