Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 09971 | Date 23/08/2021 |
| Token No | SM/21-22/4278 23/08/2021 | Serial | 022 Last Visit: 23/08/2021 |
| Patient Name | Mr. SK SANI | Contact No | 6291679419 |
| Address | 93/D , MIYAJAN DARJI LANE SERAMPORE | Age | 36 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||