Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06960 | Date 23/11/2019 |
| Token No | SM/19-20/16899 20/01/2020 | Serial | 012 Last Visit: 23/11/2020 |
| Patient Name | Mrs. FATEMA BIBI | Contact No | 9231506296 |
| Address | 1 CHATRA MUSALMAN PARA LANE, SERAMPORE | Age | 55 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||