Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04991 | Date 30/04/2019 |
| Token No | SM/19-20/2016 30/04/2019 | Serial | 084 Last Visit: 07/08/2020 |
| Patient Name | Miss AZMIRA KHATUN | Contact No | 9830974576 |
| Address | 13 CHATRA BARIN GHOSH LANE SERAMPORE | Age | 20 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 100/70 mmHg | Weight | 63.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||