Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 05259 | Date 27/05/2019 |
| Token No | SM/19-20/4926 20/06/2019 | Serial | 066 Last Visit: 27/09/2019 |
| Patient Name | Mr. ISTEKHAR ALI | Contact No | |
| Address | 16/E K.M BHATTCHARJEE STREET SERAMPORE | Age | 82 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||