Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 04443 | Date 28/03/2019 |
| Token No | SM/18-19/11443 28/03/2019 | Serial | 045 Last Visit: 28/03/2019 |
| Patient Name | Mr. PRASHANTA DAS | Contact No | 8017547353 |
| Address | SHEWRAPHULI RAM KRISHNA NAGAR, BAIDYABATI(M) | Age | 26 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 43 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||