Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 09782 | Date 02/07/2021 |
| Token No | SM/21-22/5338 22/09/2021 | Serial | 014 Last Visit: 22/09/2021 |
| Patient Name | Mr. SAMBHUNATH GHOSAL | Contact No | 8017902080 |
| Address | 88 N.S AVENUE SERAMPORE | Age | 62 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||