Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 07031 | Date 30/11/2019 |
| Token No | SM/19-20/14393 30/11/2019 | Serial | 067 Last Visit: 30/11/2019 |
| Patient Name | Mr. JOYDEB DOLUI | Contact No | 9836371149 |
| Address | 30/A NO KANAI DEWAN TALA LANE SERAMPORE | Age | 27 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||