Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 01669 | Date 13/10/2018 |
| Token No | SM/18-19/2883 13/10/2018 | Serial | 037 Last Visit: 13/10/2018 |
| Patient Name | Mr. SOMNATH SINGH ROY | Contact No | 9231900312 |
| Address | 12/C BAHIR SERAMPORE | Age | 32 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||