Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 02858 | Date 07/01/2019 |
| Token No | SM/18-19/6379 07/01/2019 | Serial | 033 Last Visit: 14/01/2019 |
| Patient Name | Mr. MALAY DAS | Contact No | 8017902081 |
| Address | 21 N.N RAY STREET SERAMPORE | Age | 34 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||