Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05627 | Date 29/06/2019 |
| Token No | SM/19-20/5642 29/06/2019 | Serial | 075 Last Visit: 29/06/2019 |
| Patient Name | Mr. ROHIT GHOSH | Contact No | 7890272122 |
| Address | 35 PROF K.K MUKHERJEE SARANI CHATRA SERAMPORE | Age | 18 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 39 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||