Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05098 | Date 14/05/2019 |
| Token No | SM/19-20/2706 14/05/2019 | Serial | 020 Last Visit: 14/05/2019 |
| Patient Name | Mrs. HALIMA SK | Contact No | |
| Address | 3/A CHATRA MUSALMAN PARA BYE LANE SERAMPORE | Age | 28 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | 110/70 mmHg | Weight | 62 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||