Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 03228 | Date 30/01/2019 |
| Token No | SM/20-21/29266 11/01/2021 | Serial | 028 Last Visit: 16/03/2023 |
| Patient Name | Mr. PREMCHAND SHA | Contact No | 9874558881 |
| Address | 10 LBS ROAD SERAMPORE | Age | 40 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||