Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00961 | Date 06/09/2018 |
| Token No | SM/19-20/5322 25/06/2019 | Serial | 078 Last Visit: 21/12/2019 |
| Patient Name | Mr. CHANCHAL SEN GUPTA | Contact No | 9051441319 |
| Address | 11 P.N MUKHERJEE STREET | Age | 60 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||