Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 07715 | Date 05/03/2020 |
| Token No | SM/19-20/19147 05/03/2020 | Serial | 028 Last Visit: 05/03/2020 |
| Patient Name | Mr. RABI DAS | Contact No | 9093535017 |
| Address | 31 NO MUSALMAN PARA ROAD SERAMPORE | Age | 34 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 71 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||