Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04084 | Date 08/03/2019 |
| Token No | SM/19-20/6125 09/07/2019 | Serial | 030 Last Visit: 06/02/2020 |
| Patient Name | Mr. TAPAN KUNDU | Contact No | 9830473837 |
| Address | CHATRA BOU BAJAR GOILA PARA LANE SERAMPORE | Age | 48 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 59 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||