Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06049 | Date 05/08/2019 |
| Token No | SM/19-20/7922 05/08/2019 | Serial | 061 Last Visit: 20/08/2019 |
| Patient Name | Mr. MD SUBEJAN | Contact No | |
| Address | 21 MUSALMAN PARA BY LANE CHATRA SERAMPORE | Age | 75 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | 130/80 mmHg | Weight | 75 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||