Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06124 | Date 16/08/2019 |
| Token No | SM/19-20/8480 16/08/2019 | Serial | 063 Last Visit: 16/08/2019 |
| Patient Name | Mrs. SAJAHAN BIBI | Contact No | |
| Address | CHATRA MUSALMANPARA KANAHAIDEWAN TALA LANE, SERAMPORE | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 47 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||