Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06943 | Date 21/11/2019 |
| Token No | SM/19-20/13717 21/11/2019 | Serial | 055 Last Visit: 14/01/2022 |
| Patient Name | Mrs. RUBAIYA BEGAM | Contact No | 6291803503 |
| Address | 121 A.P GHOSH ROAD , CHATRA SERAMPORE | Age | 40 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||