Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03847 | Date 25/02/2019 |
| Token No | SM/18-19/10292 11/03/2019 | Serial | 001 Last Visit: 20/03/2019 |
| Patient Name | Mr. ASHOK BENERJEE | Contact No | 8334977622 |
| Address | 54/N BAHIR SERAMPORE ROAD | Age | 52 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||