Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 04483 | Date 30/03/2019 |
| Token No | SM/18-19/11637 30/03/2019 | Serial | 052 Last Visit: 30/03/2019 |
| Patient Name | Mr. JITEN RAY | Contact No | 9681074828 |
| Address | 56 N.N RAY STREET SERAMPORE | Age | 36 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 59 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||