Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05092 | Date 13/05/2019 |
| Token No | SM/19-20/3376 25/05/2019 | Serial | 002 Last Visit: 25/05/2019 |
| Patient Name | Mr. BASUDEB GANGULY | Contact No | 8981578820 |
| Address | 93(40) SATCHASI PARA LANKAR BAGAN , BAIDYABATI(M) | Age | 55 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||