Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 04409 | Date 27/03/2019 |
| Token No | SM/18-19/11299 27/03/2019 | Serial | 003 Last Visit: 01/04/2019 |
| Patient Name | Mr. RABIRAN DAS | Contact No | 8420165224 |
| Address | SHEWRAPHULI RADHA GOBINDA COLLNEY, BAIDYABATI(M) | Age | 54 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||