Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 09749 | Date 24/06/2021 |
| Token No | SM/21-22/2522 24/06/2021 | Serial | 023 Last Visit: 25/06/2021 |
| Patient Name | Mr. SALIL KUMAR BANERJEE | Contact No | 9433641742 |
| Address | 2,DHARMATALA BYE LANE SERAMPORE | Age | 68 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||