Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02044 | Date 20/11/2018 |
| Token No | SM/19-20/9371 29/08/2019 | Serial | 012 Last Visit: 03/04/2020 |
| Patient Name | Mr. JAYDEB PAKIRA | Contact No | 7596898351 |
| Address | MILKI BADAM TALA, SERAMPORE GRAM PANCHAYAT | Age | 50 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||