Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05784 | Date 15/07/2019 |
| Token No | SM/19-20/6533 15/07/2019 | Serial | 076 Last Visit: 15/07/2019 |
| Patient Name | Mrs. HOSENARA | Contact No | |
| Address | 17/A MUSALMANPARA /LANE SERAMPORE(M) | Age | 48 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||