Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 03158 | Date 24/01/2019 |
| Token No | SM/18-19/7605 30/01/2019 | Serial | 035 Last Visit: 30/01/2019 |
| Patient Name | Mr. RAMENDRA NATH MONDAL | Contact No | 9830400745 |
| Address | 5/A ROY MC BAHADUR STREET SERAMPORE | Age | 63 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 63 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||