Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 07013 | Date 29/11/2019 |
| Token No | SM/20-21/30893 19/03/2021 | Serial | 002 Last Visit: 23/03/2021 |
| Patient Name | Mr. TAPAS CHATTERJEE | Contact No | 9433641596 |
| Address | 11/H RAJA K.L GOSWAMI STREET NEAR RAJBATI SERAMPORE | Age | 53 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||