Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 09073 | Date 18/12/2020 |
| Token No | SM/20-21/28575 18/12/2020 | Serial | 023 Last Visit: 18/12/2020 |
| Patient Name | Mr. SUMIT DEY | Contact No | 9330012728 |
| Address | 75 DEY STREET SERAMPORE | Age | 35 YRS Male |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||