Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 08397 | Date 20/06/2020 |
| Token No | SM/19-20/23423 25/06/2020 | Serial | 062 Last Visit: 25/06/2020 |
| Patient Name | Mr. MD NIYAMATULLAH | Contact No | 9681756556 |
| Address | 11 T.C GOSWAMI STREET SERAMPORE | Age | 32 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||