Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 06587 | Date 30/09/2019 |
| Token No | SM/19-20/11397 01/10/2019 | Serial | 015 Last Visit: 01/10/2019 |
| Patient Name | Mr. SAYAN MAJUMDAR | Contact No | 8420317051 |
| Address | 2 M. G. ROAD | Age | 18 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||