Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 04496 | Date 01/04/2019 |
| Token No | SM/19-20/45 01/04/2019 | Serial | 046 Last Visit: 01/04/2019 |
| Patient Name | Mr. SAMIR GHOSH | Contact No | 9163424399 |
| Address | 31 T.P BHATTCHARJEE STREET SERAMPORE | Age | 50 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 71 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||