Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04315 | Date 20/03/2019 |
| Token No | SM/18-19/11117 25/03/2019 | Serial | 037 Last Visit: 25/03/2019 |
| Patient Name | Mr. TAPAN BRAT | Contact No | 9073225029 |
| Address | NAGA DAKHIN TALA , BAIDYABATI(M) | Age | 60 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 42 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||