Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 05446 | Date 15/06/2019 |
| Token No | SM/19-20/4651 15/06/2019 | Serial | 034 Last Visit: 20/06/2019 |
| Patient Name | Mr. AINUL HAQUE | Contact No | 9903107642 |
| Address | 53 PANCHU GOPAL BHADURI SARANI SERAMPORE | Age | 80 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||