Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05781 | Date 15/07/2019 |
| Token No | SM/19-20/6529 15/07/2019 | Serial | 072 Last Visit: 15/07/2019 |
| Patient Name | Mr. AMAL KUMAR BANERJEE | Contact No | 9830742447 |
| Address | CHATRA CHOWDHURY PARA /LANE | Age | 59 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 69 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||