Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 06469 | Date 19/09/2019 |
| Token No | SM/19-20/10679 19/09/2019 | Serial | 061 Last Visit: 19/09/2019 |
| Patient Name | Mrs. NAZMA BIBI | Contact No | 9051940911 |
| Address | 5F GOPINATH SAHA STREET SERMPORE(M) | Age | 50 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 57 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||