Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04696 | Date 13/04/2019 |
| Token No | SM/19-20/855 13/04/2019 | Serial | 015 Last Visit: 17/07/2019 |
| Patient Name | Mr. INDRAMANI PANDIT | Contact No | 8013281308 |
| Address | SATHGHORA PASCHIMPARA KHAPUKUR SERAMPORE HOOGHLY | Age | 27 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 57.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||