Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 06737 | Date 23/10/2019 |
| Token No | SM/19-20/15357 16/12/2019 | Serial | 021 Last Visit: 17/04/2020 |
| Patient Name | Mr. SHANWAZ MONDAL | Contact No | 7044879699 |
| Address | 9 MIYA JAN DARJI LANE , SERAMPORE MALLICK PARA | Age | 60 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||