Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 06035 | Date 02/08/2019 |
| Token No | SM/19-20/7769 02/08/2019 | Serial | 001 Last Visit: 26/11/2019 |
| Patient Name | Mr. BIPLAB CHAKRABORTY | Contact No | 9051118656 |
| Address | 19 CHTRA BAJAR ROAD SERAMPORE | Age | 27 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||