Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 05474 | Date 18/06/2019 |
| Token No | SM/19-20/4811 18/06/2019 | Serial | 069 Last Visit: 18/06/2019 |
| Patient Name | Mr. TAPAN KUMAR SHA | Contact No | 9874637964 |
| Address | 10 LBS ROAD SERAMPORE | Age | 55 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 63 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||