Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 06775 | Date 01/11/2019 |
| Token No | SM/19-20/12578 01/11/2019 | Serial | 025 Last Visit: 01/11/2019 |
| Patient Name | Mr. SUBRATA ADAK | Contact No | 8697736544 |
| Address | 164A N.S AVENUE SERAMPORE | Age | 45 YRS Male |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||