Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 07643 | Date 27/02/2020 |
| Token No | SM/19-20/19045 04/03/2020 | Serial | 019 Last Visit: 04/03/2020 |
| Patient Name | Mrs. FIROZA BIBI | Contact No | 8478871700 |
| Address | 29/B/2 MIYAJAN DORJI LANE , MALLICKPARA SERAMPORE | Age | 39 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||