Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 07245 | Date 28/12/2019 |
| Token No | SM/19-20/17886 10/02/2020 | Serial | 062 Last Visit: 06/05/2020 |
| Patient Name | Mr. SUSHANTA DAS | Contact No | 8420158889 |
| Address | 2 DOCTOR BAGAN LANE SERAMPORE MALLICK PARA | Age | 49 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 59 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||