Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03312 | Date 02/02/2019 |
| Token No | SM/18-19/7850 02/02/2019 | Serial | 039 Last Visit: 24/05/2019 |
| Patient Name | Mr. SOMNATH CHAKRABORTI | Contact No | 9874939204 |
| Address | 14/A LAHIRI PARA,CHATRA | Age | 42 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 53 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||