Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03174 | Date 25/01/2019 |
| Token No | SM/20-21/26276 05/10/2020 | Serial | 012 Last Visit: 19/12/2020 |
| Patient Name | Mr. SAMIR PAN | Contact No | 9830775541 |
| Address | 69 A P GHOSH ROAD, SERAMPORE | Age | 68 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||