Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 00380 | Date 13/08/2018 |
| Token No | SM/18-19/465 14/08/2018 | Serial | 006 Last Visit: 29/09/2022 |
| Patient Name | Mr. GOPIBALLAV MANNA | Contact No | 9007462311 |
| Address | 16A, CHAKRABORTY LANE SERAMPORE | Age | 86 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||