Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 04577 | Date 05/04/2019 |
| Token No | SM/19-20/358 05/04/2019 | Serial | 064 Last Visit: 14/05/2019 |
| Patient Name | Mrs. ASMINA BIBI | Contact No | 6290525218 |
| Address | 63 N.N RAY STREET SERAMPORE | Age | 21 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 64 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||