Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05132 | Date 16/05/2019 |
| Token No | SM/19-20/2847 16/05/2019 | Serial | 009 Last Visit: 16/05/2019 |
| Patient Name | Mr. KRISHANU DAS | Contact No | 9748064739 |
| Address | 36A CHATRA DUTTA PARA SERAMPORE | Age | 28 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 43 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||