Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04020 | Date 05/03/2019 |
| Token No | SM/19-20/798 12/04/2019 | Serial | 035 Last Visit: 12/04/2019 |
| Patient Name | Mr. SUMAN DAS | Contact No | 8617744725 |
| Address | 4/B DR. GC GOSWAMI STREET SERAMPORE | Age | 32 yrs Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 78 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||