Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02539 | Date 15/12/2018 |
| Token No | SM/19-20/11340 30/09/2019 | Serial | 013 Last Visit: 16/03/2020 |
| Patient Name | Mr. SAMIR DEY SARKAR | Contact No | 8101170757 |
| Address | 4 CHOWDHURY PARA LANE | Age | 67 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 67 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||