Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06730 | Date 22/10/2019 |
| Token No | SM/19-20/15311 14/12/2019 | Serial | 076 Last Visit: 08/02/2020 |
| Patient Name | Mr. SHANTI DAS | Contact No | 9123837018 |
| Address | 50 BARO BAGAN , SERAMPORE | Age | 70 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||