Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 01976 | Date 15/11/2018 |
| Token No | SM/18-19/3723 15/11/2018 | Serial | 018 Last Visit: 15/11/2018 |
| Patient Name | Mr. NIRUPAM GHOSH | Contact No | 9939246622 |
| Address | CHATRA SHITLATALA , BAIDYABATI (M) | Age | 25 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||