Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03099 | Date 21/01/2019 |
| Token No | SM/19-20/8771 20/08/2019 | Serial | 050 Last Visit: 03/05/2021 |
| Patient Name | Mr. SAMARENDRA NATH DUTTA | Contact No | 7278209101 |
| Address | 52/24/D CHATRA GODER BAGAN,BAIDYABATY(M) | Age | 70 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 47 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||