Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 02861 | Date 07/01/2019 |
| Token No | SM/18-19/6386 07/01/2019 | Serial | 040 Last Visit: 07/01/2019 |
| Patient Name | Mr. SANJAY LAHA | Contact No | 9088363736 |
| Address | 73/1 CHATRA SHITLATALA , BAIDYABATI (M) | Age | 32 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 63 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||