Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02563 | Date 17/12/2018 |
| Token No | SM/18-19/5918 28/12/2018 | Serial | 060 Last Visit: 01/04/2019 |
| Patient Name | Mr. DEBASHIS MUKHERJEE | Contact No | 9874122675 |
| Address | 3 J M LEHIRI LANE | Age | 54 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 80 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||