Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 04880 | Date 24/04/2019 |
| Token No | SM/19-20/1536 24/04/2019 | Serial | 006 Last Visit: 24/04/2019 |
| Patient Name | Mr. KALIPADA NASKAR | Contact No | 8777840481 |
| Address | 27, CHAKRABORTY LANE CHATRA SERAMPORE | Age | 45 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||