Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 04560 | Date 05/04/2019 |
| Token No | SM/19-20/5415 26/06/2019 | Serial | 079 Last Visit: 26/06/2019 |
| Patient Name | Mr. SUDIPTA SAHA | Contact No | 9874358570 |
| Address | 10 LAL BAHADUR SHASTRI ROAD SERAMPORE | Age | 24 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||