Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01392 | Date 27/09/2018 |
| Token No | SM/18-19/5982 29/12/2018 | Serial | 037 Last Visit: 18/06/2019 |
| Patient Name | Mr. KANCHAN CHAKRABORTY | Contact No | 9874723211 |
| Address | 2/A LAHIRI PARA LANE CHATRA | Age | 52 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||