Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 04823 | Date 22/04/2019 |
| Token No | SM/19-20/1390 22/04/2019 | Serial | 105 Last Visit: 22/04/2019 |
| Patient Name | Mrs. JULEKHA KHATUN | Contact No | 9903107642 |
| Address | 54 PG BAHADUR SARANI NEAR TINBAZAR SERAMPORE | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 130/80 mmHg | Weight | 63 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||