Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02040 | Date 19/11/2018 |
| Token No | SM/18-19/3910 19/11/2018 | Serial | 077 Last Visit: 19/11/2018 |
| Patient Name | Mr. SUROJIT MITRA | Contact No | 9820748769 |
| Address | 32A/1 BHADURI LANE CHATRA SERAMPORE | Age | 32 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||