Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 08128 | Date 22/04/2020 |
| Token No | SM/19-20/21631 27/04/2020 | Serial | 058 Last Visit: 27/04/2020 |
| Patient Name | Mrs. PHOOLJAN PARBIN | Contact No | 9088690179 |
| Address | 2 PARSHILANE SERAMPORE | Age | 24 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 42 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||