Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04806 | Date 22/04/2019 |
| Token No | SM/19-20/1326 22/04/2019 | Serial | 041 Last Visit: 22/04/2019 |
| Patient Name | Mr. KHOKAN CHANDRA DAS | Contact No | 8478092673 |
| Address | PRAMODPALLY, DAKSHIN RAJDHARPUR, SERAMPORE | Age | 57 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 58 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||