Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 08645 | Date 18/08/2020 |
| Token No | SM/19-20/25193 26/08/2020 | Serial | 003 Last Visit: 26/08/2020 |
| Patient Name | Mr. SK RAMJAN | Contact No | 9330102898 |
| Address | 49/A NO CHATRA MUSALMANPARA ROAD SERAMPORE | Age | 32 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||