Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 04257 | Date 16/03/2019 |
| Token No | SM/19-20/1282 20/04/2019 | Serial | 103 Last Visit: 05/08/2019 |
| Patient Name | Mrs. JAMILA QURASHI | Contact No | 7450916105 |
| Address | 36/B MIAJAN DARJEE LANE MALLIK PARA , SERAMPORE | Age | 36 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 58 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||