Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04781 | Date 20/04/2019 |
| Token No | SM/19-20/1239 20/04/2019 | Serial | 060 Last Visit: 20/04/2019 |
| Patient Name | Mr. JANO RANJAN LAHIRI | Contact No | 8336825945 |
| Address | 12 CHAPA TALA LANE SERAMPORE | Age | 84 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||