Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02912 | Date 09/01/2019 |
| Token No | SM/18-19/6885 16/01/2019 | Serial | 031 Last Visit: 06/02/2020 |
| Patient Name | Mr. JAYANTA KR. GHOSH | Contact No | 8582863811 |
| Address | 7 PARAN CHANDRA DAS LANE | Age | 62 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||