Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 09459 | Date 12/04/2021 |
| Token No | SM/21-22/403 12/04/2021 | Serial | 038 Last Visit: 12/04/2021 |
| Patient Name | Mr. ASIM KR. CHATTOPADHYAY | Contact No | 9051062947 |
| Address | 25(19)CHAKRABORTY LANE NEAR PRAYASI CLUB,SITALATALA CHATRA,SERAMPORE | Age | 63 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||