Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05978 | Date 27/07/2019 |
| Token No | SM/19-20/10684 19/09/2019 | Serial | 066 Last Visit: 19/09/2019 |
| Patient Name | Mr. SAMARENDRA NATH BANERJEE | Contact No | 9748004677 |
| Address | 24 FLAT NO 302 BAZAR ROAD SERAMPORE CHATRA | Age | 70 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||