Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 04981 | Date 30/04/2019 |
| Token No | SM/19-20/1975 30/04/2019 | Serial | 043 Last Visit: 30/04/2019 |
| Patient Name | Mr. SOUMITRA MONDAL | Contact No | 9123949902 |
| Address | 16 RAJA K.L GOSWAMI STREET SERAMPORE | Age | 34 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 51 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||