Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 05141 | Date 16/05/2019 |
| Token No | SM/19-20/2880 16/05/2019 | Serial | 042 Last Visit: 16/05/2019 |
| Patient Name | Mr. OMPRAKASH RAM | Contact No | 6291453020 |
| Address | 13 N.N ROY STREET SERAMPORE | Age | 43 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||