Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 02879 | Date 07/01/2019 |
| Token No | SM/18-19/6426 07/01/2019 | Serial | 080 Last Visit: 07/01/2019 |
| Patient Name | Mr. MD PIR | Contact No | 7890264707 |
| Address | SERAMPORE KACHARI BASA | Age | 50 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||