Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04617 | Date 08/04/2019 |
| Token No | SM/19-20/490 08/04/2019 | Serial | 054 Last Visit: 26/06/2019 |
| Patient Name | Mrs. JAHARA BEGAM | Contact No | 8981596529 |
| Address | 129 A P GHOSH ROAD | Age | 58 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 57 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||