Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 01143 | Date 14/09/2018 |
| Token No | SM/18-19/4508 01/12/2018 | Serial | 035 Last Visit: 05/11/2019 |
| Patient Name | Mr. SANAT KUMAR DAS | Contact No | 9836079361 |
| Address | 52 CHAKRABORTY LANE | Age | 54.0 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 39 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||