Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 08716 | Date 08/09/2020 |
| Token No | SM/19-20/25519 08/09/2020 | Serial | 033 Last Visit: 08/09/2020 |
| Patient Name | Mr. SK SIRAJ | Contact No | 8240852522 |
| Address | 7 ARABINDA SARANI SERAMPOREN | Age | 22 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||