Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04815 | Date 22/04/2019 |
| Token No | SM/19-20/21274 17/04/2020 | Serial | 042 Last Visit: 17/04/2020 |
| Patient Name | Mr. SK NAUSAD | Contact No | 9831167549 |
| Address | 7/A CHATRA ARBINDA SARANI SERAMPORE | Age | 32 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||