Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 07200 | Date 20/12/2019 |
| Token No | SM/19-20/16807 17/01/2020 | Serial | 028 Last Visit: 17/01/2020 |
| Patient Name | Mr. INDRANIL LAHIRI | Contact No | 9088197943 |
| Address | 6 RAY M.C LAHIRI BAHADUR STREET CHATRA SERAMPORE | Age | 34 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||