Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 03629 | Date 18/02/2019 |
| Token No | SM/18-19/8838 18/02/2019 | Serial | 011 Last Visit: 18/02/2019 |
| Patient Name | Mr. SOURAV SARKAR | Contact No | |
| Address | 10 GOILA PARA LANE SERAMPORE | Age | 36 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 63 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||