Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 00422 | Date 14/08/2018 |
| Token No | SM/18-19/5651 22/12/2018 | Serial | 028 Last Visit: 27/02/2019 |
| Patient Name | Mr. TAPAN KR. CHATTERJEE | Contact No | 9830895360 |
| Address | 61, THAKURDAS BABU LANE | Age | 68 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 59 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||