Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 05226 | Date 25/05/2019 |
| Token No | SM/19-20/3392 25/05/2019 | Serial | 018 Last Visit: 25/05/2019 |
| Patient Name | Mrs. MOMINA KHATUN | Contact No | 8697506892 |
| Address | KAJIPARA , BAIDYABATI(M) | Age | 22 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 68 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||