Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 09079 | Date 21/12/2020 |
| Token No | SM/20-21/28621 21/12/2020 | Serial | 014 Last Visit: 21/12/2020 |
| Patient Name | Mr. BABUL KUNDU | Contact No | 9830183516 |
| Address | 16 NO BARIN GHOSH LANE SERAMPORE | Age | 50 yrs Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||