Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05916 | Date 24/07/2019 |
| Token No | SM/19-20/7164 24/07/2019 | Serial | 006 Last Visit: 24/07/2019 |
| Patient Name | Mrs. JULI BIBI | Contact No | 7044231041 |
| Address | CHATRA KANAHAI DEWAN TALA SERAMPORE | Age | 35 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 83.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||