Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 05512 | Date 21/06/2019 |
| Token No | SM/19-20/5369 26/06/2019 | Serial | 033 Last Visit: 08/06/2022 |
| Patient Name | Mr. GOUTAM DAS | Contact No | 9432472807 |
| Address | 30B AC CHTERJEE SARANI (BYE SERAMPORE) | Age | 52YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||