Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04374 | Date 25/03/2019 |
| Token No | SM/18-19/11166 25/03/2019 | Serial | 086 Last Visit: 25/03/2019 |
| Patient Name | Mr. SANDIP NAG | Contact No | 9875691856 |
| Address | CHATRA KUMAR PARA SERAMPORE | Age | 31 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 66.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||