Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 04397 | Date 26/03/2019 |
| Token No | SM/18-19/11249 26/03/2019 | Serial | 042 Last Visit: 26/03/2019 |
| Patient Name | Mr. PABAN DAS | Contact No | 9088416956 |
| Address | 12 TARAPUKUR LANE SERAMPORE (M) | Age | 65 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 58 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||