Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 07182 | Date 18/12/2019 |
| Token No | SM/19-20/15551 18/12/2019 | Serial | 061 Last Visit: 18/12/2019 |
| Patient Name | Mr. BHOLA RAY | Contact No | 7059319118 |
| Address | 10 B HARI PARA LANE SERAMPORE | Age | 34 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||