Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 07265 | Date 31/12/2019 |
| Token No | SM/19-20/16105 31/12/2019 | Serial | 047 Last Visit: 31/12/2019 |
| Patient Name | Mr. LAKSHMIKANTA DAS | Contact No | 9748337803 |
| Address | 14 DHARMATALA BYE LANE CHATRA , SERAMPORE | Age | 45 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 84 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||