Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03624 | Date 18/02/2019 |
| Token No | SM/18-19/10130 08/03/2019 | Serial | 021 Last Visit: 08/03/2019 |
| Patient Name | Mr. KALICHARAN KOTAL | Contact No | 9830932436 |
| Address | CHATRA LANKAR BAGAN, (BAIDYABATI) | Age | 62 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 51 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||