Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 06742 | Date 23/10/2019 |
| Token No | SM/19-20/12280 23/10/2019 | Serial | 018 Last Visit: 01/11/2019 |
| Patient Name | Mrs. MINATI BEGAM | Contact No | 9883083934 |
| Address | 76/B MALLICKPARA LANE SERAMPORE | Age | 57 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||