Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 06800 | Date 06/11/2019 |
| Token No | SM/19-20/12755 06/11/2019 | Serial | 008 Last Visit: 06/11/2019 |
| Patient Name | Mr. ALIMUDDIN KHAN | Contact No | 9051744610 |
| Address | 28 CHILEKHANA ROAD SERAMPORE MALLICKPARA | Age | 54 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||