Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 04555 | Date 04/04/2019 |
| Token No | SM/19-20/274 04/04/2019 | Serial | 063 Last Visit: 04/04/2019 |
| Patient Name | Mr. MALAY CHAKRABORTY | Contact No | 8100244474 |
| Address | 37 N C CHAKRABORTY LANE,BAIDYABATI(M) | Age | 63 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 68 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||