Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 07085 | Date 05/12/2019 |
| Token No | SM/19-20/15437 16/12/2019 | Serial | 101 Last Visit: 16/12/2019 |
| Patient Name | Mr. RAGHU DAS | Contact No | 8697124655 |
| Address | 3/C DOCTOR BAGAN LANE SERAMPORE MALLICK PARA | Age | 55 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||