Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04209 | Date 15/03/2019 |
| Token No | SM/18-19/10535 15/03/2019 | Serial | 028 Last Visit: 15/03/2019 |
| Patient Name | Mr. SUBHANKAR SANTRA | Contact No | 7003415335 |
| Address | SHEWRAPHULI SARKAR PARA , BAIDYABATI(M) | Age | 20 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 64 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||