Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05632 | Date 29/06/2019 |
| Token No | SM/19-20/20101 21/03/2020 | Serial | 057 Last Visit: 21/03/2020 |
| Patient Name | Mr. ASIM KUMAR BANERJEE | Contact No | 9433947602 |
| Address | 5B GHSOH PARA 2 ND LANE SERAMPORE | Age | 72 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 52 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||