Ticket for Outdoor Patient
| Ward No. 8 | U-PHC No. | Registration No. 03106 | Date 21/01/2019 |
| Token No | SM/18-19/7552 29/01/2019 | Serial | 045 Last Visit: 29/01/2019 |
| Patient Name | Mr. GOPAL SHAW | Contact No | 8276959992 |
| Address | 30/D LIBARARY LANE SERAMPORE HOOGHLY | Age | 16 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 82 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||