Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 04176 | Date 11/03/2019 |
| Token No | SM/18-19/10394 11/03/2019 | Serial | 103 Last Visit: 11/03/2019 |
| Patient Name | Mr. SAMBHUNATH GHOSH | Contact No | 8335939671 |
| Address | 25/1/C MC LAHIRI STREETCHATRA SERAMPORE | Age | 65 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 72 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||