Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 00788 | Date 28/08/2018 |
| Token No | SM/18-19/1939 22/09/2018 | Serial | 052 Last Visit: 30/03/2019 |
| Patient Name | Mr. MANIK DAS | Contact No | 9874047551 |
| Address | 72/47 SHTLATALA CHATRA , BAIDYABATI(M) | Age | 55 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | 150/100 mmHg | Weight | 61 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||