Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 05105 | Date 14/05/2019 |
| Token No | SM/19-20/2747 14/05/2019 | Serial | 061 Last Visit: 14/05/2019 |
| Patient Name | Mrs. RAMICHA BIBI | Contact No | 6291320343 |
| Address | 45 MALLIK PARA SERAMPORE | Age | 65 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 150/90 mmHg | Weight | 46 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||