Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 04751 | Date 18/04/2019 |
| Token No | SM/19-20/1691 26/04/2019 | Serial | 003 Last Visit: 10/05/2019 |
| Patient Name | Mrs. SAMINA BIBI | Contact No | 6290893151 |
| Address | 14 BAZAR BYE LANE SERAMPORE | Age | 41 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 48 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||