Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04194 | Date 13/03/2019 |
| Token No | SM/18-19/10490 13/03/2019 | Serial | 017 Last Visit: 13/03/2019 |
| Patient Name | Mr. JAYNTA BANERJEE | Contact No | 9748700761 |
| Address | 7/C/2 CHATRA GHOSH PARA 1ST LANE | Age | 61 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 63 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||