Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02797 | Date 03/01/2019 |
| Token No | SM/18-19/6722 14/01/2019 | Serial | 013 Last Visit: 06/07/2021 |
| Patient Name | Mr. ASHIM KUMAR BANERJEE | Contact No | 9433947602 |
| Address | 5/B GHOSH PARA 2ND LANE CHATRA SERAMPORE | Age | 73YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 53 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||