Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06260 | Date 28/08/2019 |
| Token No | SM/19-20/9359 28/08/2019 | Serial | 082 Last Visit: 28/08/2019 |
| Patient Name | Mr. MD SUFEK ANSARI | Contact No | |
| Address | CHATRA MUSALMAN PARA SERAMPORE | Age | 42 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||