Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05191 | Date 22/05/2019 |
| Token No | SM/19-20/3173 22/05/2019 | Serial | 014 Last Visit: 22/05/2019 |
| Patient Name | Mr. DEBENDRANATH BANERJEE | Contact No | 9433118066 |
| Address | 136 MC LAHIRI STREET SERAMPORE | Age | 67 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||