Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 06807 | Date 06/11/2019 |
| Token No | SM/19-20/15062 11/12/2019 | Serial | 041 Last Visit: 12/11/2021 |
| Patient Name | Mr. RAHAMAT ALI | Contact No | 908836369 |
| Address | 20 PARSI LANE SERAMPORE | Age | 45 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||