Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 08231 | Date 06/05/2020 |
| Token No | SM/19-20/22010 06/05/2020 | Serial | 035 Last Visit: 16/09/2021 |
| Patient Name | Mrs. TABASSUM KHATUN | Contact No | |
| Address | 13 K.M BHATTARYA STREET SERAMPORE | Age | 50 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 57.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||