Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 07450 | Date 01/02/2020 |
| Token No | SM/19-20/17429 01/02/2020 | Serial | 040 Last Visit: 01/02/2020 |
| Patient Name | Miss EPSITA DHUL | Contact No | 9477974202 |
| Address | 37 SANIPARA LANE SERAMPORWE MALLICKPARA | Age | 22 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 58 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||