Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 06547 | Date 26/09/2019 |
| Token No | SM/19-20/11139 26/09/2019 | Serial | 023 Last Visit: 26/09/2019 |
| Patient Name | Mrs. KHAIRUN NISHA BIBI | Contact No | 8820952462 |
| Address | 6 T. C .GOSWAMI STREET | Age | 55 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||