Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02549 | Date 15/12/2018 |
| Token No | SM/21-22/2999 08/07/2021 | Serial | 021 Last Visit: 17/07/2021 |
| Patient Name | Mr. SANKAR CHAKRABORTY | Contact No | 8617218100 |
| Address | 2/A CHAMPA TALA LANE | Age | 29 YRS Male |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||