Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 02200 | Date 29/11/2018 |
| Token No | SM/18-19/8679 14/02/2019 | Serial | 044 Last Visit: 23/02/2019 |
| Patient Name | Mr. GULAM SABIR | Contact No | 9062376411 |
| Address | 25 MUSALMAN PARA LANE , SERAMPORE | Age | 83 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||