Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05903 | Date 23/07/2019 |
| Token No | SM/19-20/7112 23/07/2019 | Serial | 050 Last Visit: 23/07/2019 |
| Patient Name | Mr. SHAIL SARKAR | Contact No | 8697256096 |
| Address | 166 MAHESH COLONY SERAMPORE | Age | 47 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||