Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 04461 | Date 29/03/2019 |
| Token No | SM/18-19/11527 29/03/2019 | Serial | 035 Last Visit: 29/03/2019 |
| Patient Name | Mr. MD FAIM | Contact No | 9123782148 |
| Address | 4 K.M BHATTCHARJEE STREET SERAMPORE | Age | 22 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 61 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||