Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02366 | Date 06/12/2018 |
| Token No | SM/18-19/4752 06/12/2018 | Serial | 007 Last Visit: 12/06/2020 |
| Patient Name | Mr. SANJAY DAS | Contact No | 8013648998 |
| Address | 13 CHATRA HARIJAN ROAD , BAIDYABATI (M) | Age | 30 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 47 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||