Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 05189 | Date 22/05/2019 |
| Token No | SM/19-20/3892 03/06/2019 | Serial | 015 Last Visit: 13/01/2020 |
| Patient Name | Mrs. NAJMA BIBI | Contact No | 7980325063 |
| Address | 16 HIGH STREET SILBAGAN SERAMPORE | Age | 44 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 51 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||