Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03581 | Date 14/02/2019 |
| Token No | SM/19-20/6568 16/07/2019 | Serial | 016 Last Visit: 16/07/2019 |
| Patient Name | Mr. SK SERAJUL | Contact No | 6289448032 |
| Address | 4/A ARABINDA SWARANI | Age | 60 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||