Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05973 | Date 27/07/2019 |
| Token No | SM/19-20/7411 27/07/2019 | Serial | 023 Last Visit: 06/08/2019 |
| Patient Name | Mr. SUKUMAR SOM | Contact No | 9748204936 |
| Address | 116/A CHATRA BARUI PARA LANE SERAMPORE | Age | 74 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||