Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 03765 | Date 21/02/2019 |
| Token No | SM/19-20/14356 30/11/2019 | Serial | 030 Last Visit: 12/12/2019 |
| Patient Name | Mr. ISHTHAKAR ALI | Contact No | 9330529847 |
| Address | K.M BHATTCHARYA STREET SERAMPORE HOOGHLY | Age | 86 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||