Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03157 | Date 24/01/2019 |
| Token No | SM/18-19/7348 24/01/2019 | Serial | 035 Last Visit: 11/03/2019 |
| Patient Name | Mr. DILIP BANERJEE | Contact No | 9432542461 |
| Address | CHOWDHURY PARA LANE | Age | 67 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 80 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||