Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 05155 | Date 20/05/2019 |
| Token No | SM/19-20/2963 20/05/2019 | Serial | 011 Last Visit: 20/05/2019 |
| Patient Name | Mrs. SAMSAD BEGAM | Contact No | 8697457027 |
| Address | 18 NO PARSI LANE SERAMPORE | Age | 30 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 46 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||