Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 06881 | Date 16/11/2019 |
| Token No | SM/19-20/13341 16/11/2019 | Serial | 001 Last Visit: 18/11/2019 |
| Patient Name | Mr. UDAY SHANKAR GHATAK | Contact No | 8001675096 |
| Address | 9, G.C GOSWAMI STREET SERAMPORE | Age | 63 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||