Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 04530 | Date 03/04/2019 |
| Token No | SM/19-20/1056 17/04/2019 | Serial | 063 Last Visit: 28/07/2020 |
| Patient Name | Mr. CHANDAN JISWARA | Contact No | 9433178665 |
| Address | 11, RABINDRA BHAWAN SERAMPORE COURT | Age | 35 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 76 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||