Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 09006 | Date 01/12/2020 |
| Token No | SM/20-21/27912 01/12/2020 | Serial | 014 Last Visit: 01/12/2020 |
| Patient Name | Mr. SK NIJAM | Contact No | 9330577268 |
| Address | 22C CHATRA KUMAR BYE LANE SERAMPORE | Age | 19 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||