Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 05388 | Date 11/06/2019 |
| Token No | SM/19-20/4385 11/06/2019 | Serial | 061 Last Visit: 09/08/2019 |
| Patient Name | Mr. MD GOLAM NASIR QURAISHI | Contact No | 8334884258 |
| Address | 107/C G.T ROAD , BAIDYABATI(M) | Age | 50 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | 110/70 mmHg | Weight | 57 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||