Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06679 | Date 17/10/2019 |
| Token No | SM/19-20/11964 17/10/2019 | Serial | 074 Last Visit: 17/10/2019 |
| Patient Name | Mr. SK AYUB ALI | Contact No | 9088358742 |
| Address | 40 MUSALMAN PRA ROAD SERAMPORE | Age | 29 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 59 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||