Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05941 | Date 24/07/2019 |
| Token No | SM/19-20/7245 24/07/2019 | Serial | 087 Last Visit: 24/07/2019 |
| Patient Name | Miss JAHIDA KHATUN | Contact No | 6291852758 |
| Address | 7 ARBINDA SARANI SERAMPORE | Age | 18 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||