Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 07027 | Date 30/11/2019 |
| Token No | SM/19-20/14590 03/12/2019 | Serial | 073 Last Visit: 06/12/2019 |
| Patient Name | Mr. BALARAM PAL | Contact No | 9903910106 |
| Address | 32 NO KUMOR PARA LANE CHATRA SERAMPORE | Age | 48 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 63 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||