Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 04161 | Date 11/03/2019 |
| Token No | SM/18-19/10363 11/03/2019 | Serial | 072 Last Visit: 11/03/2019 |
| Patient Name | Mr. BASNTA ACHARYA | Contact No | 9681286398 |
| Address | CHARA BAGAN BAURI PARA , BAIDYABATI(M) | Age | 38 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 61 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||