Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 07054 | Date 03/12/2019 |
| Token No | SM/19-20/14580 03/12/2019 | Serial | 063 Last Visit: 03/12/2019 |
| Patient Name | Mr. SUMANTA MUKHERJEE | Contact No | 7890822804 |
| Address | 142 RAMKRISHNA ROAD SERAMPORE, BAIDYABATI(M) | Age | 51 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 80 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||