Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 06137 | Date 16/08/2019 |
| Token No | SM/19-20/8535 16/08/2019 | Serial | 118 Last Visit: 16/08/2019 |
| Patient Name | Mr. SOUMEN DEY | Contact No | 9804131406 |
| Address | 2 CHATRA DUTTA PARA LANE SERAMPORE | Age | 33 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 47 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||