Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03345 | Date 04/02/2019 |
| Token No | SM/19-20/13547 19/11/2019 | Serial | 044 Last Visit: 19/11/2019 |
| Patient Name | Mr. NABA GOPAL BANERJEE | Contact No | 8430360731 |
| Address | 16, DHARMATALA LANE CHATRA | Age | 59 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 59 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||