Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 06902 | Date 19/11/2019 |
| Token No | SM/19-20/13521 19/11/2019 | Serial | 018 Last Visit: 19/11/2019 |
| Patient Name | Mrs. SAHISTA PARVEEN | Contact No | 8100843476 |
| Address | 12B/1 RABINDRA BHAWAN ROAD SERAMPORE | Age | 20 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 42 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||