Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05276 | Date 28/05/2019 |
| Token No | SM/19-20/3625 28/05/2019 | Serial | 066 Last Visit: 19/07/2019 |
| Patient Name | Mr. DEB KUMAR CHATERJEE | Contact No | |
| Address | 18 CHATRA CHOWDHURY PARA SERAMPORE | Age | 70 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | 100/70 mmHg | Weight | 42 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||