Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03759 | Date 21/02/2019 |
| Token No | SM/18-19/10530 15/03/2019 | Serial | 023 Last Visit: 26/08/2019 |
| Patient Name | Mr. NANI LAL GHUCHAIT | Contact No | 9804672309 |
| Address | 39 CHATRA SACHTASI PARA, BAIDYABATI (M) | Age | 57 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||