Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 04361 | Date 25/03/2019 |
| Token No | SM/18-19/11490 28/03/2019 | Serial | 092 Last Visit: 28/03/2019 |
| Patient Name | Mr. RAM BALAK RAY | Contact No | 9830599285 |
| Address | 10 M.G ROAD SERAMPORE HOOGHLY | Age | 52 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||