Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 03749 | Date 21/02/2019 |
| Token No | SM/19-20/7987 06/08/2019 | Serial | 008 Last Visit: 03/09/2019 |
| Patient Name | Mr. SHYAMAL SHA | Contact No | 8617275617 |
| Address | 10 LBS ROAD SERAMPORE | Age | 50 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 58 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||