Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 03227 | Date 30/01/2019 |
| Token No | SM/19-20/8079 07/08/2019 | Serial | 022 Last Visit: 07/08/2019 |
| Patient Name | Mr. BISWAJIT SHA | Contact No | 9874558881 |
| Address | 10 LBS ROAD SERAMPORE HOOGHLY | Age | 42 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 62 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||