Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06772 | Date 31/10/2019 |
| Token No | SM/19-20/12543 31/10/2019 | Serial | 064 Last Visit: 31/10/2019 |
| Patient Name | Mrs. AMINA BIBI | Contact No | 7001081624 |
| Address | 4/A CHATRA ARBINDA SARANI SERAMPORE | Age | 25 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||