Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 07096 | Date 06/12/2019 |
| Token No | SM/19-20/14799 06/12/2019 | Serial | 056 Last Visit: 06/12/2019 |
| Patient Name | Mrs. BEGAM SARINA SEKH | Contact No | |
| Address | 48 MUSALMAN PARA ROAD , SERAMPORE | Age | 44 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||