Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04379 | Date 25/03/2019 |
| Token No | SM/18-19/11179 25/03/2019 | Serial | 099 Last Visit: 11/04/2019 |
| Patient Name | Mr. SHANKAR DAS | Contact No | 7595859749 |
| Address | DHULI PARA SERAMPORE | Age | 72 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 42 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||