Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 00925 | Date 05/09/2018 |
| Token No | SM/18-19/4329 28/11/2018 | Serial | 061 Last Visit: 02/01/2019 |
| Patient Name | Mr. SHYAMAL MITRA | Contact No | 9836620359 |
| Address | 10/G/1 ROY M.C LAHIRI STREET BAHADUR STREET SERAMPORE | Age | 65 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | 170/90 mmHg | Weight | 59 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||