Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04377 | Date 25/03/2019 |
| Token No | SM/18-19/11175 25/03/2019 | Serial | 095 Last Visit: 28/03/2019 |
| Patient Name | Mr. MD ISMAIL | Contact No | |
| Address | CHATRA MUSALMAN PRA BYE LANE SERAMPORE | Age | 25 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||