Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 09725 | Date 15/06/2021 |
| Token No | SM/21-22/2278 15/06/2021 | Serial | 014 Last Visit: 15/06/2021 |
| Patient Name | Mr. SK. ABDUL MOIZ | Contact No | 9163933840 |
| Address | 31/A CHATRA MUSHALMAN PARA SERAMPORE | Age | 65 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||