Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06905 | Date 19/11/2019 |
| Token No | SM/19-20/13533 19/11/2019 | Serial | 030 Last Visit: 19/11/2019 |
| Patient Name | Mrs. SAHJAHAN BEGAM | Contact No | 9836760751 |
| Address | 21 CHATRA KUMARPARA SERAMPORE | Age | 59 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||