Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 05208 | Date 23/05/2019 |
| Token No | SM/19-20/12263 23/10/2019 | Serial | 001 Last Visit: 23/10/2019 |
| Patient Name | Mr. FRANCIS SIMON | Contact No | 9163177847 |
| Address | A/58/Y TARAPUKUR GOV. QUTER | Age | 31 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||