Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 06962 | Date 23/11/2019 |
| Token No | SM/19-20/13816 23/11/2019 | Serial | 011 Last Visit: 23/11/2019 |
| Patient Name | Mr. MD SALEKIN | Contact No | 7003857249 |
| Address | T.C. GOSWAMI STREET, SERAMPORE | Age | 25 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||