Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03021 | Date 16/01/2019 |
| Token No | SM/18-19/10461 12/03/2019 | Serial | 052 Last Visit: 23/03/2020 |
| Patient Name | Mr. SWAPAN BANERJEE | Contact No | 8481954667 |
| Address | CHATRA BAGER BAGAN, BAIDYABATI(M) | Age | 50 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||