Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 06091 | Date 09/08/2019 |
| Token No | SM/19-20/8210 09/08/2019 | Serial | 017 Last Visit: 01/10/2019 |
| Patient Name | Mrs. RUSINA PARVEEN | Contact No | 8583896687 |
| Address | 29/B/2 MIYAZAN DARJI LANE SERAMPORE | Age | 26 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||