Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04683 | Date 12/04/2019 |
| Token No | SM/19-20/4216 08/06/2019 | Serial | 064 Last Visit: 28/08/2020 |
| Patient Name | Mr. ASIT DAS | Contact No | 9903712458 |
| Address | 10 G.C GOSWAMI STREET SERAMPORE | Age | 54 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 68 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||