Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00255 | Date 09/08/2018 |
| Token No | SM/18-19/3834 19/11/2018 | Serial | 001 Last Visit: 13/12/2018 |
| Patient Name | Mr. GOPAL CHATTERJEE | Contact No | 9830788390 |
| Address | 11 J.M LAHIRI LANE | Age | 78.0 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||