Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 02709 | Date 28/12/2018 |
| Token No | SM/18-19/5859 28/12/2018 | Serial | 001 Last Visit: 25/09/2019 |
| Patient Name | Mr. NAKU ROY | Contact No | 9903254101 |
| Address | BAURI PARA CHARABAGAN SHEORAPHULI , BAIDYABATI(M) | Age | 85 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 37 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||