Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06387 | Date 12/09/2019 |
| Token No | SM/19-20/10254 12/09/2019 | Serial | 072 Last Visit: 16/12/2019 |
| Patient Name | Mr. MD AMIR QURAISHI | Contact No | 8013814706 |
| Address | 107/C GT ROAD , BAIDYABATI(M) | Age | 24 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 63 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||