Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06713 | Date 21/10/2019 |
| Token No | SM/19-20/12155 21/10/2019 | Serial | 052 Last Visit: 02/04/2020 |
| Patient Name | Mrs. NISHA SINGH | Contact No | 9163104938 |
| Address | 42/A BARA BAGAN LANE SERAMPORE , MALLICK PARA | Age | 20 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||