Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 02698 | Date 27/12/2018 |
| Token No | SM/18-19/5808 27/12/2018 | Serial | 066 Last Visit: 27/12/2018 |
| Patient Name | Mr. SOHEL PARWEZ | Contact No | 9681660398 |
| Address | 25/A T.C GOSWAMI STREET | Age | 18 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||