Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06062 | Date 06/08/2019 |
| Token No | SM/19-20/16770 16/01/2020 | Serial | 049 Last Visit: 24/08/2020 |
| Patient Name | Mr. SUBIR DAS | Contact No | 8100475295 |
| Address | 36 CHAKRABARTI LANE SERAMPORE | Age | 69 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 70 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||