Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 00167 | Date 16/09/2019 |
| Token No | SM/19-20/182 16/09/2019 | Serial | 046 |
| Patient Name | Mrs. HASINA BIBI | Contact No | 9433247625 |
| Address | 26/A MIYAJAN DARJEE LANE SERAMPORE 712203 | Age | 60 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 120/80 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||