Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 07369 | Date 20/01/2020 |
| Token No | SM/19-20/19055 04/03/2020 | Serial | 029 Last Visit: 09/05/2020 |
| Patient Name | Mrs. FATEMA KHATUN | Contact No | 7890543022 |
| Address | 47 CHATRA MUSALMAN PARA SERAMPORE | Age | 34 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 59 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||