Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 04625 | Date 08/04/2019 |
| Token No | SM/19-20/519 08/04/2019 | Serial | 083 Last Visit: 08/04/2019 |
| Patient Name | Mr. SUKUMER DAS | Contact No | 9830604468 |
| Address | BORO BAGAN, SERAMPORE | Age | 60 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 42 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||