Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 07857 | Date 19/03/2020 |
| Token No | SM/19-20/19947 19/03/2020 | Serial | 050 Last Visit: 19/03/2020 |
| Patient Name | Mrs. GULSONA BIBI | Contact No | 8697360257 |
| Address | 91/D MIYAJAN DARJI LANE SERAMPORE | Age | 34 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 39 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||