Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 06756 | Date 25/10/2019 |
| Token No | SM/19-20/12388 25/10/2019 | Serial | 004 Last Visit: 01/11/2019 |
| Patient Name | Mr. SUBAL CHANDA | Contact No | 9681538237 |
| Address | 20 DR G.C GOSWAMI STREET SERAMPORE | Age | 48 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||