Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05900 | Date 23/07/2019 |
| Token No | SM/19-20/7108 23/07/2019 | Serial | 046 Last Visit: 23/07/2019 |
| Patient Name | Mrs. MEHRUNESA BIBI | Contact No | 9903772347 |
| Address | 5 ARBINDA SARANI CHATRA, SERAMPORE | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 70 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||