Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 07161 | Date 16/12/2019 |
| Token No | SM/19-20/15477 17/12/2019 | Serial | 028 Last Visit: 17/12/2019 |
| Patient Name | Mrs. MANIRA BEGUM | Contact No | 7890484108 |
| Address | 47 CHATRA MUSALMAN PARA ASERAMPORE | Age | 35 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 71 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||