Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 02675 | Date 24/12/2018 |
| Token No | SM/19-20/2653 13/05/2019 | Serial | 064 Last Visit: 02/07/2021 |
| Patient Name | Mr. MD AKTER | Contact No | 7449644348 |
| Address | 27/A MALLIK PARA, MIA DARJI LANE SERAMPORE | Age | 50 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 76 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||