Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 08739 | Date 15/09/2020 |
| Token No | SM/20-21/25682 15/09/2020 | Serial | 007 Last Visit: 06/10/2020 |
| Patient Name | Mrs. REHENA BIBI | Contact No | 8013238117 |
| Address | 9 NO MIYA JAN DARJI LANE SERAMPORE MALLICKPARA | Age | 48 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||