Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 06193 | Date 21/08/2019 |
| Token No | SM/19-20/8919 21/08/2019 | Serial | 081 Last Visit: 21/08/2019 |
| Patient Name | Mr. SHANKAR HARI | Contact No | 9681828262 |
| Address | 22 ROY GHAT LANE SERAMPORE | Age | 42 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||