Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02403 | Date 07/12/2018 |
| Token No | SM/18-19/5472 19/12/2018 | Serial | 036 Last Visit: 06/01/2020 |
| Patient Name | Mr. SHYAMAL KUMAR DAS | Contact No | 7890090585 |
| Address | 1/1A CHATRA DUTTA PARA SERAMPORE | Age | 60 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 101 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||