Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 05091 | Date 13/05/2019 |
| Token No | SM/19-20/2646 13/05/2019 | Serial | 057 Last Visit: 13/05/2019 |
| Patient Name | Mr. KANHAI LAL CHAKRABORTY | Contact No | 8481847289 |
| Address | 62 THAKURDAS BABAU LANE GOSAI PARA SERAMPORE | Age | 45 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||