Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 05266 | Date 28/05/2019 |
| Token No | SM/19-20/3577 28/05/2019 | Serial | 018 Last Visit: 28/05/2019 |
| Patient Name | Mr. PABITRA KUMAR DAS | Contact No | 9883200220 |
| Address | 32 CHAKRABORTY LANE SERAMPORE | Age | 38 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||