Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04976 | Date 30/04/2019 |
| Token No | SM/19-20/1958 30/04/2019 | Serial | 026 Last Visit: 30/04/2019 |
| Patient Name | Mrs. TABINA BIBI | Contact No | 6289568085 |
| Address | 36A CHATRA MUSALMAN PARA SERAMPORE | Age | 24 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 76 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||