Ticket for Outdoor Patient
| Ward No. 25 | U-PHC No. | Registration No. 05096 | Date 13/05/2019 |
| Token No | SM/19-20/8890 21/08/2019 | Serial | 052 Last Visit: 21/08/2019 |
| Patient Name | Mr. TARAK DEBNATH | Contact No | 9875469913 |
| Address | 3/49 MAHESH COLONY SERAMPORE | Age | 61 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 42 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||