Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03516 | Date 12/02/2019 |
| Token No | SM/18-19/8491 12/02/2019 | Serial | 095 Last Visit: 12/02/2019 |
| Patient Name | Mr. ANIRUDDHA KHAN | Contact No | 9804657459 |
| Address | 39A/5 CHATRA BARUI PARA LANE | Age | 20 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 70 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||