Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 04351 | Date 23/03/2019 |
| Token No | SM/18-19/11061 23/03/2019 | Serial | 065 Last Visit: 05/04/2019 |
| Patient Name | Mr. MD CHANDU | Contact No | 9903980753 |
| Address | 63 N.N ROY STREET SERAMPORE | Age | 52 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||