Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 06148 | Date 19/08/2019 |
| Token No | SM/19-20/8624 19/08/2019 | Serial | 078 Last Visit: 19/08/2019 |
| Patient Name | Mrs. SAMINA BIBI | Contact No | 8420342814 |
| Address | MALLICK PARA BARA MAHSHID, SERAMPORE | Age | 31 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 69 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||