Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02169 | Date 28/11/2018 |
| Token No | SM/18-19/4273 28/11/2018 | Serial | 005 Last Visit: 22/02/2019 |
| Patient Name | Mr. ASHOK BHATTACHARJEE | Contact No | 9007418388 |
| Address | 13, P.N MUKHERJEE STREET | Age | 65 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 72 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||