Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 04289 | Date 18/03/2019 |
| Token No | SM/19-20/3098 21/05/2019 | Serial | 046 Last Visit: 21/05/2019 |
| Patient Name | Mrs. RUBJAN BIBI | Contact No | 6290525218 |
| Address | 63 N.N ROY STREET SERAMPORE | Age | 32 yrs Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 51 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||