Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05171 | Date 21/05/2019 |
| Token No | SM/19-20/3056 21/05/2019 | Serial | 004 Last Visit: 21/05/2019 |
| Patient Name | Mr. KUNTAL PAL | Contact No | 7029265941 |
| Address | CHATRA KUMAR PARA SERAMPORE | Age | 24 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 51 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||