Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 04057 | Date 07/03/2019 |
| Token No | SM/18-19/10053 07/03/2019 | Serial | 056 Last Visit: 07/03/2019 |
| Patient Name | Mr. ANIL SHAW | Contact No | 6291710064 |
| Address | 10/K MC LAHIRI STREET | Age | 34 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 67 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||