Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 05046 | Date 08/05/2019 |
| Token No | SM/19-20/2390 08/05/2019 | Serial | 081 Last Visit: 22/07/2019 |
| Patient Name | Mrs. FATEMA BIBI | Contact No | 8981565149 |
| Address | 4 K .M. BHATTACHARYA STREET | Age | 70 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 68 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||