Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04747 | Date 17/04/2019 |
| Token No | SM/19-20/1069 17/04/2019 | Serial | 076 Last Visit: 17/04/2019 |
| Patient Name | Mrs. TAYABA KHATUN | Contact No | 9984182023 |
| Address | CHATRA SIDESWARI TALA , SERAMPORE(M) | Age | 28 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||