Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 07403 | Date 22/01/2020 |
| Token No | SM/19-20/17062 22/01/2020 | Serial | 043 Last Visit: 22/01/2020 |
| Patient Name | Mr. MRINMOY PAL | Contact No | 7003942160 |
| Address | 102 NO A.P GHOSH ROAD CHATRA SERAMPORE HOOGHLY | Age | 36 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 70 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||