Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03105 | Date 21/01/2019 |
| Token No | SM/19-20/1000 17/04/2019 | Serial | 007 Last Visit: 17/04/2019 |
| Patient Name | Mr. TAPAN DAS | Contact No | 9836528476 |
| Address | 3/C CHATRA GHOSH PARA 1ST LANE SERAMPORE | Age | 71 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 90 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||