Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05541 | Date 24/06/2019 |
| Token No | SM/19-20/5187 24/06/2019 | Serial | 053 Last Visit: 26/06/2019 |
| Patient Name | Mr. FAJAL ALI | Contact No | 7679837714 |
| Address | 127 CHATRA, GHOSH PARA, | Age | 50 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||