Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 05269 | Date 28/05/2019 |
| Token No | SM/19-20/3585 28/05/2019 | Serial | 026 Last Visit: 28/05/2019 |
| Patient Name | Mr. PRITAM SIULY | Contact No | 9123346411 |
| Address | 5/B TARAPUKUR COLONY SERAMPORE | Age | 21 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 90 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||