Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04489 | Date 30/03/2019 |
| Token No | SM/18-19/11651 30/03/2019 | Serial | 066 Last Visit: 30/03/2019 |
| Patient Name | Mr. KANAI DUTTA | Contact No | 9674806109 |
| Address | 93 CHATRA BARUI PARA SERAMPORE | Age | 74 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||