Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 01182 | Date 18/09/2018 |
| Token No | SM/18-19/6889 16/01/2019 | Serial | 035 Last Visit: 16/01/2019 |
| Patient Name | Mr. ANWAR ALLI | Contact No | |
| Address | 12 SHIL BAGAN, SERAMPORE | Age | 62 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 67 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||