Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05894 | Date 22/07/2019 |
| Token No | SM/19-20/7057 22/07/2019 | Serial | 075 Last Visit: 29/02/2020 |
| Patient Name | Mr. SK SALIM | Contact No | 8910850967 |
| Address | 45B CHATRA MUSALMAN PARA SERAMPORE | Age | 36 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 63 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||