Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06843 | Date 13/11/2019 |
| Token No | SM/19-20/13109 13/11/2019 | Serial | 036 Last Visit: 02/12/2019 |
| Patient Name | Mr. SK RUMJAN | Contact No | 9830576930 |
| Address | 41 MUSALMAN PARA ROAD SERAMPORE | Age | 50 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 64 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||