Ticket for Outdoor Patient
| Ward No. 21 | U-PHC No. | Registration No. 00668 | Date 24/08/2018 |
| Token No | SM/19-20/3934 03/06/2019 | Serial | 057 Last Visit: 13/07/2019 |
| Patient Name | Mrs. RAHIMA BIBI | Contact No | |
| Address | 66 N.S ROAD SARKAR PARA , BAIDYABATI(M) | Age | 50 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||