Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 03240 | Date 30/01/2019 |
| Token No | SM/19-20/6180 10/07/2019 | Serial | 048 Last Visit: 04/05/2020 |
| Patient Name | Mrs. JELEHER BIBI | Contact No | 7449346436 |
| Address | MALLICK PARA,MEYAJON DARJI LANE | Age | 72 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||