Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00664 | Date 24/08/2018 |
| Token No | SM/19-20/13714 21/11/2019 | Serial | 052 Last Visit: 10/02/2020 |
| Patient Name | Mr. AJAY KUMAR BAGCHI | Contact No | 9007753630 |
| Address | 13, DR. P.N MUKHERJEE STREET | Age | 65 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||