Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 07154 | Date 16/12/2019 |
| Token No | SM/19-20/15339 16/12/2019 | Serial | 003 Last Visit: 16/12/2019 |
| Patient Name | Mrs. REKSONA KHATUN | Contact No | 9330514001 |
| Address | CHARA BAGAN BARUI PARA , BAIDYABATI(M) | Age | 25 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||