Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02276 | Date 01/12/2018 |
| Token No | SM/19-20/16356 07/01/2020 | Serial | 064 Last Visit: 07/01/2020 |
| Patient Name | Mr. SANJEET BANERJEE | Contact No | 8017536871 |
| Address | 29A CHATRA BAJAR ROAD | Age | 48 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||