Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03389 | Date 05/02/2019 |
| Token No | SM/18-19/8074 05/02/2019 | Serial | 065 Last Visit: 22/02/2019 |
| Patient Name | Mr. SK MOBARACK | Contact No | 9339444555 |
| Address | 47 CHATRA M P ROAD,SERAMPORE, | Age | 42 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 64 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||