Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00442 | Date 14/08/2018 |
| Token No | SM/19-20/5084 22/06/2019 | Serial | 045 Last Visit: 08/07/2019 |
| Patient Name | Mr. JYOTISANKAR GANGULY | Contact No | 9804261986 |
| Address | 3/E, CHATRA DUTTA PARA LANE | Age | 30.0 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||