Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05297 | Date 30/05/2019 |
| Token No | SM/19-20/3734 30/05/2019 | Serial | 027 Last Visit: 30/05/2019 |
| Patient Name | Mrs. SALMA KHATUN | Contact No | 8597483576 |
| Address | 40 CHATRA MUSALMAN PARA SERAMPORE | Age | 26 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 82 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||