Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 04008 | Date 05/03/2019 |
| Token No | SM/19-20/2553 11/05/2019 | Serial | 041 Last Visit: 23/10/2021 |
| Patient Name | Mrs. JINAT BEGAM | Contact No | 8017230758 |
| Address | 34 MUSALMAN PARA LANE SERAMPORE | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 47 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||