Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01446 | Date 01/10/2018 |
| Token No | SM/18-19/6324 05/01/2019 | Serial | 039 Last Visit: 22/07/2019 |
| Patient Name | Mr. AMIT DAS | Contact No | 9051399610 |
| Address | 42/26 HARIJAN ROAD CHATRA DAS PARA , BAIDYABATI (M) | Age | 38 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 68 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||