Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06329 | Date 04/09/2019 |
| Token No | SM/19-20/9782 04/09/2019 | Serial | 013 Last Visit: 04/09/2019 |
| Patient Name | Mrs. ASIFA KHATUN | Contact No | |
| Address | 45 N.N RAY STREET SERAMPORE | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 41 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||