Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06967 | Date 23/11/2019 |
| Token No | SM/19-20/13849 23/11/2019 | Serial | 044 Last Visit: 23/11/2019 |
| Patient Name | Mr. TAPAN DAS | Contact No | 9007971018 |
| Address | 22 P.N.K.B LANE CHATRA SERAMPORE | Age | 39 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||