Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 05265 | Date 28/05/2019 |
| Token No | SM/19-20/5623 29/06/2019 | Serial | 056 Last Visit: 29/06/2019 |
| Patient Name | Mr. SONA HARI | Contact No | |
| Address | JITEN LAHIRI ROAD SERAMPORE | Age | 42 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||