Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 05183 | Date 21/05/2019 |
| Token No | SM/19-20/3142 21/05/2019 | Serial | 090 Last Visit: 21/05/2019 |
| Patient Name | Mr. SARBAN KUMAR | Contact No | 7890414023 |
| Address | 4 LBS ROAD TINBAJAR SERAMPORE | Age | 32 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 59 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||