Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03641 | Date 18/02/2019 |
| Token No | SM/18-19/8876 18/02/2019 | Serial | 049 Last Visit: 18/02/2019 |
| Patient Name | Mr. SUNDESWAR ROY | Contact No | |
| Address | 6/6 BAISNAV PARA SERAMPORE | Age | 48 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||