Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 06440 | Date 17/09/2019 |
| Token No | SM/19-20/10513 17/09/2019 | Serial | 004 Last Visit: 17/09/2019 |
| Patient Name | Mr. SASHI SINGH | Contact No | 9874992688 |
| Address | 56, K.M BHATTACHARYA STREET SERAMPORE | Age | 23 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||