Ticket for Outdoor Patient
| Ward No. 25 | U-PHC No. | Registration No. 03095 | Date 19/01/2019 |
| Token No | SM/18-19/7111 19/01/2019 | Serial | 044 Last Visit: 25/01/2019 |
| Patient Name | Mr. LAL BABU DAS | Contact No | 9883686157 |
| Address | JANNAGAR ROAD KATAPUL KALI TALA | Age | 50 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 42.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||