Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 04813 | Date 22/04/2019 |
| Token No | SM/19-20/1347 22/04/2019 | Serial | 062 Last Visit: 22/04/2019 |
| Patient Name | Miss SABNAM BANU | Contact No | 8334073986 |
| Address | 56 N.N RAY STREET SERAMPORE | Age | 21 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 52 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||