Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 01557 | Date 06/10/2018 |
| Token No | SM/18-19/6131 02/01/2019 | Serial | 040 Last Visit: 16/04/2019 |
| Patient Name | Mr. MAKSUD ALAM | Contact No | 9339742590 |
| Address | 47, N.N RAY STREET SERAMPORE | Age | 75 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 67 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||