Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04179 | Date 12/03/2019 |
| Token No | SM/19-20/6826 19/07/2019 | Serial | 016 Last Visit: 09/11/2021 |
| Patient Name | Mr. GOBINDALAL CHATTERJEE | Contact No | 8017827950 |
| Address | 11 JAGA MOHAN LAHIRI LANE, CHATRA, SERAMPORE | Age | 78 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 73 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||