Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 04530 | Date 03/04/2019 |
| Token No | SM/19-20/17960 12/02/2020 | Serial | 070 Last Visit: 28/07/2020 |
| Patient Name | Mr. CHANDAN JISWARA | Contact No | 9433178665 |
| Address | 11, RABINDRA BHAWAN SERAMPORE COURT | Age | 35 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||