Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 05040 | Date 08/05/2019 |
| Token No | SM/19-20/2364 08/05/2019 | Serial | 055 Last Visit: 08/05/2019 |
| Patient Name | Mr. SUMIT MUKHERJEE | Contact No | 7980679826 |
| Address | 76 N.N ROY STREET SERAMPORE | Age | 19 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 80 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||