Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 05127 | Date 15/05/2019 |
| Token No | SM/19-20/2828 15/05/2019 | Serial | 068 Last Visit: 15/05/2019 |
| Patient Name | Mr. MD MOBIN | Contact No | 9874150886 |
| Address | 88 MIA JAN DARJI LANE MALIK PARA SERAMPORE | Age | 52 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | 100/70 mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||