Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 08584 | Date 24/07/2020 |
| Token No | SM/19-20/24416 24/07/2020 | Serial | 033 Last Visit: 24/07/2020 |
| Patient Name | Mr. ALFRED HALSONA | Contact No | 8697873889 |
| Address | 33/1 KUMIR JELA ROAD SERAMPORE | Age | 52 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||