Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03655 | Date 18/02/2019 |
| Token No | SM/18-19/8906 18/02/2019 | Serial | 079 Last Visit: 02/11/2020 |
| Patient Name | Mr. JAHANARA BEGAM | Contact No | 8981596529 |
| Address | 129 A. P. GHOSH ROAD, SERAMPORE | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 35 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||