Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 05789 | Date 15/07/2019 |
| Token No | SM/19-20/6543 15/07/2019 | Serial | 086 Last Visit: 27/07/2019 |
| Patient Name | Mr. GOBINDA SINGH | Contact No | 6291275865 |
| Address | PACHU BAZAR 9 GARAL BAGAN LANE | Age | 30 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||