Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05268 | Date 28/05/2019 |
| Token No | SM/19-20/5124 22/06/2019 | Serial | 085 Last Visit: 06/08/2019 |
| Patient Name | Mr. RAJKUMAR PAL | Contact No | 9903165351 |
| Address | 27/1 KUMAR PARA LANE SERAMPORE | Age | 44 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 64 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||