Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04476 | Date 30/03/2019 |
| Token No | SM/18-19/11619 30/03/2019 | Serial | 034 Last Visit: 30/03/2019 |
| Patient Name | Mr. SURAJIT GHOSH | Contact No | 8697944937 |
| Address | 6/A A.P GHSOH ROAD SERAMPORE | Age | 29 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 63 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||