Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 06365 | Date 11/09/2019 |
| Token No | SM/19-20/10095 11/09/2019 | Serial | 002 Last Visit: 11/09/2019 |
| Patient Name | Mr. MD SORIF | Contact No | 8981565149 |
| Address | 14 PARSI LANE SIL BAGAN SERAMPORE | Age | 22 YRS Male |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||