Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 07214 | Date 23/12/2019 |
| Token No | SM/19-20/15752 23/12/2019 | Serial | 002 Last Visit: 23/12/2019 |
| Patient Name | Mr. SK SAMSED ALI | Contact No | 8017870485 |
| Address | BARAKHEJURIA HOOGHLY CHINSURAH | Age | 38 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 59 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||