Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04796 | Date 22/04/2019 |
| Token No | SM/19-20/1292 22/04/2019 | Serial | 007 Last Visit: 17/07/2019 |
| Patient Name | Mr. SISIR DAS | Contact No | 7044734161 |
| Address | 14 SIDDHESWARI LANE SERAMPORE | Age | 59 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||