Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 09179 | Date 16/01/2021 |
| Token No | SM/20-21/29428 16/01/2021 | Serial | 005 Last Visit: 16/01/2021 |
| Patient Name | Mr. BANKIM BANERJEE | Contact No | 6291231299 |
| Address | 66/1/G/1 RAMKRISHNA ROAD, BAIDYABATI(M) | Age | 62 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||