Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 10381 | Date 04/12/2021 |
| Token No | SM/21-22/7457 04/12/2021 | Serial | 009 Last Visit: 22/06/2022 |
| Patient Name | Mr. SURESH BANERJEE | Contact No | 8584821978 |
| Address | 18/ BARUI PARA LANE SERAMPORE | Age | 43 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||