Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 05890 | Date 22/07/2019 |
| Token No | SM/19-20/7030 22/07/2019 | Serial | 048 Last Visit: 22/07/2019 |
| Patient Name | Mr. MD SAFI | Contact No | |
| Address | K.M BHATTCHARYA STREET SILBAGAN | Age | 60 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||