Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 02349 | Date 05/12/2018 |
| Token No | SM/19-20/5316 25/06/2019 | Serial | 072 Last Visit: 25/06/2019 |
| Patient Name | Mr. SOURAV MAJHI | Contact No | 9883289767 |
| Address | 362 1/A GT ROAD CHATRA SERAMPORE | Age | 21 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 72 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||