Ticket for Outdoor Patient
| Ward No. 21 | U-PHC No. | Registration No. 02839 | Date 05/01/2019 |
| Token No | SM/18-19/6318 05/01/2019 | Serial | 033 Last Visit: 05/01/2019 |
| Patient Name | Mr. SWAPAN KUMAR CHAKRABORTY | Contact No | 9804786804 |
| Address | 270B N.S ROAD MALLICK BAGAN , BAIDYABATI(M) | Age | 64 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 62 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||