Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 04811 | Date 22/04/2019 |
| Token No | SM/19-20/1341 22/04/2019 | Serial | 056 Last Visit: 22/04/2019 |
| Patient Name | Mrs. AISA BEGAM | Contact No | 9830254771 |
| Address | 59B MALIK PARA SERAMPORE | Age | 38 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 64 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||