Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 03540 | Date 13/02/2019 |
| Token No | SM/18-19/8561 13/02/2019 | Serial | 028 Last Visit: 13/02/2019 |
| Patient Name | Mr. KALYAN SEAL | Contact No | 9830564119 |
| Address | 1/A MOTILAL SEL LANE, | Age | 68 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||