Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 03245 | Date 31/01/2019 |
| Token No | SM/18-19/7635 31/01/2019 | Serial | 009 Last Visit: 31/01/2019 |
| Patient Name | Mr. UTTAM DAS | Contact No | |
| Address | CHAK GOYLA PARA,BAIDYABATY (M) | Age | 46 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 57 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||