Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05919 | Date 24/07/2019 |
| Token No | SM/19-20/7175 24/07/2019 | Serial | 017 Last Visit: 24/07/2019 |
| Patient Name | Mr. UJJAL RAY | Contact No | 7602811943 |
| Address | CHATRA GHOSH PARA SERAMPORE | Age | 53 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||