Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 02784 | Date 02/01/2019 |
| Token No | SM/19-20/14272 29/11/2019 | Serial | 041 Last Visit: 29/11/2019 |
| Patient Name | Mr. AMAL RAY | Contact No | 9433702781 |
| Address | 42 N.N. ROY STREET SERAMPORE | Age | 68 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||