Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 05192 | Date 22/05/2019 |
| Token No | SM/19-20/12117 21/10/2019 | Serial | 014 Last Visit: 06/01/2022 |
| Patient Name | Mrs. MUMTAZ BEGAM | Contact No | 8017317110 |
| Address | 56 N.N RAY STREET SERAMPORE | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||