Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 10290 | Date 17/11/2021 |
| Token No | SM/21-22/6899 17/11/2021 | Serial | 026 Last Visit: 17/11/2021 |
| Patient Name | Mr. ABDUL BARIK SK | Contact No | 9123840939 |
| Address | MUSALMAN PARA BYE LANE SERAMPORE | Age | 54 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||