Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01589 | Date 09/10/2018 |
| Token No | SM/18-19/9902 05/03/2019 | Serial | 103 Last Visit: 19/09/2019 |
| Patient Name | Mr. SUBHAS DAS | Contact No | 8013437362 |
| Address | 10/B CHATRA DUTTA PARA, SERAMPORE | Age | 72 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||