Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 07659 | Date 28/02/2020 |
| Token No | SM/19-20/18816 28/02/2020 | Serial | 002 Last Visit: 28/02/2020 |
| Patient Name | Mr. NEMAI CHANDRA MONDAL | Contact No | 7686830295 |
| Address | 3/A BARA BAGAN LANE SERAMPORE MALLICKPARA | Age | 64 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 47 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||