Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 04681 | Date 12/04/2019 |
| Token No | SM/19-20/881 13/04/2019 | Serial | 041 Last Visit: 13/04/2019 |
| Patient Name | Mr. BUNELA SHAW | Contact No | 7685082165 |
| Address | 31 BAJAR BYE LANE TINBAJAR, SERAMPORE | Age | 25 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 77 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||