Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05133 | Date 16/05/2019 |
| Token No | SM/19-20/2850 16/05/2019 | Serial | 012 Last Visit: 16/05/2019 |
| Patient Name | Mr. PARIMAL CHATERJEE | Contact No | 9674152537 |
| Address | 85 A.P GHOSH ROAD CHATRA KALI BABU GHAT SERAMPORE | Age | 65 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||