Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 04703 | Date 16/04/2019 |
| Token No | SM/19-20/8553 19/08/2019 | Serial | 007 Last Visit: 07/07/2022 |
| Patient Name | Mr. SANJAY KUMAR KOIRI | Contact No | 8820981498 |
| Address | 79 DEY STREET SERAMPORE | Age | 32 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 59 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||