Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02994 | Date 14/01/2019 |
| Token No | SM/19-20/502 08/04/2019 | Serial | 066 Last Visit: 08/04/2019 |
| Patient Name | Mr. ASGAR ALI MOLLA | Contact No | 8768841121 |
| Address | VILL- AZAMNAGAR, PO- PASCHIM TAJPUR, HOOGHLY | Age | 52 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 75 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||