Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 05165 | Date 20/05/2019 |
| Token No | SM/19-20/3034 20/05/2019 | Serial | 082 Last Visit: 21/05/2019 |
| Patient Name | Mr. PARIMAL GHOSH | Contact No | 8181386827 |
| Address | FIRINGI DANGA ROAD 21 SERAMPORE | Age | 68 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 69 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||