Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02977 | Date 14/01/2019 |
| Token No | SM/18-19/7320 24/01/2019 | Serial | 007 Last Visit: 07/02/2019 |
| Patient Name | Mr. KAUSHIK DAS | Contact No | 8481870040 |
| Address | CHATRA LANKER BAGAN,BAIDYABATI(M) | Age | 19 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 76 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||