Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 07365 | Date 18/01/2020 |
| Token No | SM/19-20/21382 20/04/2020 | Serial | 057 Last Visit: 20/04/2020 |
| Patient Name | Mrs. SELIMA BEGAM | Contact No | 7890694607 |
| Address | 37A MUSALMAN PARA ROAD , SERAMPORE | Age | 21 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||