Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 02134 | Date 26/11/2018 |
| Token No | SM/19-20/8909 21/08/2019 | Serial | 071 Last Visit: 21/08/2019 |
| Patient Name | Mr. AFTAB ALAM | Contact No | 8981424216 |
| Address | 11/A/1 PARSHILANE SERAMPORE | Age | 22 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 63 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||