Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05129 | Date 15/05/2019 |
| Token No | SM/19-20/2833 15/05/2019 | Serial | 073 Last Visit: 15/05/2019 |
| Patient Name | Mrs. SUKHTARA BIBI | Contact No | 9088182394 |
| Address | 49/A NO CHATRA MUSALMAN PARA ROAD SERAMPORE | Age | 28 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 47 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||