Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06609 | Date 12/10/2019 |
| Token No | SM/19-20/11601 12/10/2019 | Serial | 016 Last Visit: 14/06/2021 |
| Patient Name | Mr. RAJA SAMANTA | Contact No | 7278128540 |
| Address | 25/A KHATIR BAZAR LANE SERAMPORE | Age | 31 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||