Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 05584 | Date 26/06/2019 |
| Token No | SM/19-20/5379 26/06/2019 | Serial | 043 Last Visit: 06/07/2019 |
| Patient Name | Mrs. KHODEISA BIBI | Contact No | 6291274114 |
| Address | 5 PARSHI LANE SERAMPORE | Age | 75 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 160/80 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||