Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 10404 | Date 11/12/2021 |
| Token No | SM/21-22/11007 23/03/2022 | Serial | 013 Last Visit: 23/03/2022 |
| Patient Name | Mr. MD ALI | Contact No | 8820635950 |
| Address | 42 PANCHU GOPAL BHADURI STREET | Age | 46 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||