Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 04467 | Date 29/03/2019 |
| Token No | SM/18-19/11547 29/03/2019 | Serial | 055 Last Visit: 14/02/2020 |
| Patient Name | Mr. SANJAY PRAMANIK | Contact No | 9007278225 |
| Address | 17/2 GURU DAS BHATTCHARJEE LANE CHATRA SHITLATALA , BAIDYABTI (M) | Age | 48 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 57 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||