Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 07797 | Date 14/03/2020 |
| Token No | SM/19-20/22154 12/05/2020 | Serial | 008 Last Visit: 12/05/2020 |
| Patient Name | Mr. BANABIHARI CHAKRABORTY | Contact No | 7686974977 |
| Address | 9 DR. G.C GOSWAMI STREET SERAMPORE | Age | 58 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 39 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||