Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 06650 | Date 16/10/2019 |
| Token No | SM/19-20/11822 16/10/2019 | Serial | 040 Last Visit: 16/10/2019 |
| Patient Name | Mrs. KULSUM ARA | Contact No | 9748444545 |
| Address | 56, N.N RAY STREET SERAMPORE | Age | 25 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||