Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 04147 | Date 11/03/2019 |
| Token No | SM/18-19/10327 11/03/2019 | Serial | 036 Last Visit: 11/03/2019 |
| Patient Name | Mr. DIPANKAR GHOSH | Contact No | 9748137821 |
| Address | CHATRA MANNA PARA RAMKRISHANA ROAD , BAIDYABATI(M) | Age | 38 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 59.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||