Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04506 | Date 02/04/2019 |
| Token No | SM/19-20/18538 24/02/2020 | Serial | 014 Last Visit: 30/04/2020 |
| Patient Name | Mr. MOSLEM MALLIK | Contact No | 8100412101 |
| Address | BANGIHATI SERAMPORE HOOGHLY VOTER ID -WB26/181/609087 | Age | 52 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 95 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||