Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05232 | Date 25/05/2019 |
| Token No | SM/19-20/3431 25/05/2019 | Serial | 057 Last Visit: 25/05/2019 |
| Patient Name | Mr. TANMOY PAL | Contact No | 6290458173 |
| Address | 25 CHATRA KUMAR PARA SERAMPORE | Age | 18 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||