Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 05107 | Date 15/05/2019 |
| Token No | SM/19-20/2775 15/05/2019 | Serial | 015 Last Visit: 15/05/2019 |
| Patient Name | Mr. BIKASH KUMAR SHAW | Contact No | 9804209506 |
| Address | 10 M.G ROAD SERAMPORE | Age | 21 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 73 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||