Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04741 | Date 17/04/2019 |
| Token No | SM/19-20/1048 17/04/2019 | Serial | 055 Last Visit: 12/06/2019 |
| Patient Name | Mr. SK SULTAN | Contact No | 8420071106 |
| Address | 1 CHATRA MUSALMAN PARA BYE LANE SERAMPORE | Age | 28 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 71 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||