Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 01511 | Date 04/10/2018 |
| Token No | SM/19-20/4929 20/06/2019 | Serial | 069 Last Visit: 20/06/2019 |
| Patient Name | Mrs. RABIYA BIBI | Contact No | |
| Address | 36 MUSALMAN PARA LANE SERAMPORE | Age | 38 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 57 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||