Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 07127 | Date 12/12/2019 |
| Token No | SM/19-20/15097 12/12/2019 | Serial | 017 Last Visit: 12/12/2019 |
| Patient Name | Mrs. MINARA KHATOON | Contact No | 6289009090 |
| Address | 10 TULSI CHARAN GOSWAMI STREET SERAMPORE | Age | 25 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||