Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 04958 | Date 29/04/2019 |
| Token No | SM/19-20/1849 29/04/2019 | Serial | 005 Last Visit: 29/04/2019 |
| Patient Name | Mr. AMJAD ALI | Contact No | 8481976157 |
| Address | 19 TC GOSWAMI STREET SERAMPORE | Age | 34 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 75.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||