Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05796 | Date 16/07/2019 |
| Token No | SM/19-20/6583 16/07/2019 | Serial | 031 Last Visit: 16/07/2019 |
| Patient Name | Mrs. MASURA BIBI MOLLA | Contact No | 9051217654 |
| Address | BAHARAMPUR BORA,HOOGHLY | Age | 66 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 39 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||