Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 05428 | Date 14/06/2019 |
| Token No | SM/19-20/4552 14/06/2019 | Serial | 027 Last Visit: 14/06/2019 |
| Patient Name | Mr. RIKKI HELA | Contact No | 6290185525 |
| Address | 5, K.M. BHATTACHARJEE STREET | Age | 25 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||