Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 02601 | Date 20/12/2018 |
| Token No | SM/19-20/16896 20/01/2020 | Serial | 009 Last Visit: 06/08/2020 |
| Patient Name | Mr. LAKSHMI KANT DAS | Contact No | 9239879963 |
| Address | 13A RAJA K.L GOSWAMI STREET SERAMPORE | Age | 50 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 85 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||