Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 07203 | Date 20/12/2019 |
| Token No | SM/19-20/16086 31/12/2019 | Serial | 028 Last Visit: 27/02/2020 |
| Patient Name | Mrs. JYOTSNA BIBI | Contact No | 7022744302 |
| Address | 19 CHATRA MUSALMAN PARA SERAMPORE | Age | 42 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 61 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||