Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06416 | Date 16/09/2019 |
| Token No | SM/19-20/10410 16/09/2019 | Serial | 011 Last Visit: 16/09/2019 |
| Patient Name | Mr. SK SAMIR | Contact No | 8335991216 |
| Address | 20 KUMAR PARA LANE CHATRA , SERAMPORE | Age | 22 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 42 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||