Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04007 | Date 05/03/2019 |
| Token No | SM/18-19/10334 11/03/2019 | Serial | 043 Last Visit: 08/04/2019 |
| Patient Name | Mr. KALIPADA BANERJEE | Contact No | 9088594617 |
| Address | 8 A.P GHOSH ROAD , BAIDYABATI(M) | Age | 60 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||