Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 01918 | Date 05/11/2018 |
| Token No | SM/19-20/23094 15/06/2020 | Serial | 016 Last Visit: 28/08/2020 |
| Patient Name | Mr. SK NURUDDIN AHAMED | Contact No | 8017676928 |
| Address | 9 BENGAL COAL LANE SHEORAPHULI, BAIDYABATI(M) | Age | 70 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||