Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 05315 | Date 01/06/2019 |
| Token No | SM/19-20/3857 01/06/2019 | Serial | 058 Last Visit: 14/06/2019 |
| Patient Name | Mrs. SAHIN PARVEEN | Contact No | 9681701425 |
| Address | 19 T.C GOSWAMI STREET SERAMPORE | Age | 28 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||