Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 02685 | Date 27/12/2018 |
| Token No | SM/18-19/7314 24/01/2019 | Serial | 001 Last Visit: 30/03/2019 |
| Patient Name | Mr. CHANDRIKA DAS | Contact No | 7688016535 |
| Address | CHARA BAGAN BAWRI PARA , BAIDYABATI (M) | Age | 60 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||