Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05658 | Date 02/07/2019 |
| Token No | SM/19-20/5812 02/07/2019 | Serial | 102 Last Visit: 02/07/2019 |
| Patient Name | Mr. SUMAN BANERJEE | Contact No | 9681248612 |
| Address | 12/A DUTTS LANE CHATRA SERAMPORE | Age | 34 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 73.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||