Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 04858 | Date 23/04/2019 |
| Token No | SM/19-20/1480 23/04/2019 | Serial | 061 Last Visit: 25/06/2019 |
| Patient Name | Mrs. SAIDAN KHATOON | Contact No | 9903107642 |
| Address | 53 P.G BHADURI SARANI SERAMPORE | Age | 75 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 180/100 mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||