Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 06740 | Date 23/10/2019 |
| Token No | SM/19-20/12275 23/10/2019 | Serial | 013 Last Visit: 23/10/2019 |
| Patient Name | Mrs. MUSRAT PARVEEN | Contact No | 7003964956 |
| Address | 57 N.N RAY STREET SERAMPORE | Age | 39 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 57 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||