Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 05735 | Date 11/07/2019 |
| Token No | SM/19-20/6681 17/07/2019 | Serial | 053 Last Visit: 21/03/2020 |
| Patient Name | Mr. GOUTAM PAL | Contact No | 8961457525 |
| Address | 74/A RAMKRISHNA ROAD, CHATRA, SERAMPORE, BAIDYABATI (M) | Age | 48 Y Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 49.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||