Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 07118 | Date 11/12/2019 |
| Token No | SM/19-20/15036 11/12/2019 | Serial | 015 Last Visit: 11/12/2019 |
| Patient Name | Mr. AMALENDU PAL | Contact No | 9875500856 |
| Address | 2/C TARA PUKUR COLONY , SERAMPORE | Age | 22 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||