Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 02152 | Date 27/11/2018 |
| Token No | SM/18-19/6103 02/01/2019 | Serial | 012 Last Visit: 06/01/2021 |
| Patient Name | Mr. GOKUL GHORUI | Contact No | 9007068365 |
| Address | 101 G T ROAD,PANDAB NURSARI | Age | 65 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 39 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||