Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04210 | Date 15/03/2019 |
| Token No | SM/18-19/10540 15/03/2019 | Serial | 033 Last Visit: 15/03/2019 |
| Patient Name | Mr. JAYNTA SANTRA | Contact No | 7003415335 |
| Address | SHEWRAPHULI SARKAR PARA , BAIDYABATI(M) | Age | 44 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||