Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 04862 | Date 23/04/2019 |
| Token No | SM/19-20/1488 23/04/2019 | Serial | 069 Last Visit: 23/04/2019 |
| Patient Name | Mrs. RAZIA BEGAM | Contact No | 9836386716 |
| Address | 59/B MALLIK PARA LANE SERAMPORE | Age | 47 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 110/80 mmHg | Weight | 63.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||