Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 06511 | Date 23/09/2019 |
| Token No | SM/19-20/11179 26/09/2019 | Serial | 063 Last Visit: 26/09/2019 |
| Patient Name | Mr. MD MUSHA | Contact No | 8820045799 |
| Address | 16 RABINDRA BHABAN ROAD | Age | 60 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||