Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 06694 | Date 19/10/2019 |
| Token No | SM/21-22/1089 03/05/2021 | Serial | 037 Last Visit: 13/05/2021 |
| Patient Name | Mr. RAJARAM MONDAL | Contact No | |
| Address | 79K/1 ROY STREET SERAMPORE | Age | 60 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||