Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06250 | Date 28/08/2019 |
| Token No | SM/19-20/9306 28/08/2019 | Serial | 029 Last Visit: 28/08/2019 |
| Patient Name | Mrs. RIZIA BEGAM | Contact No | 8622871663 |
| Address | 86 MALLICK PARA LANE SERAMPORE | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 62 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||