Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 09911 | Date 05/08/2021 |
| Token No | SM/21-22/3783 05/08/2021 | Serial | 015 Last Visit: 09/08/2021 |
| Patient Name | Mr. PROVATH GHOSH | Contact No | 8013908900 |
| Address | 16,RAJA K.L GHOSWAMI STREET SERAMPORE | Age | 33 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||