Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01481 | Date 03/10/2018 |
| Token No | SM/18-19/5977 29/12/2018 | Serial | 032 Last Visit: 29/12/2018 |
| Patient Name | Mr. PUSHAN GHOSH | Contact No | 8697414345 |
| Address | 18B GHOSH PARA 1ST LANE CHATRA SERAMPORE | Age | 18 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 89 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||