Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 00463 | Date 16/08/2018 |
| Token No | SM/18-19/709 21/08/2018 | Serial | 007 Last Visit: 25/09/2018 |
| Patient Name | Mr. PRABIR KUMAR PYNE | Contact No | 9831365893 |
| Address | 5 BAS TALA LANE BANIYA PARA LANE SERAMPORE HOOGHLY | Age | 71.0 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 64 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||