Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 05102 | Date 14/05/2019 |
| Token No | SM/19-20/2736 14/05/2019 | Serial | 050 Last Visit: 14/05/2019 |
| Patient Name | Mr. MD AHTESHAM | Contact No | 7003288195 |
| Address | 5 PARSI LANE SILBAGAN SERAMPORE | Age | 25 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||