Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 02941 | Date 10/01/2019 |
| Token No | SM/18-19/7831 02/02/2019 | Serial | 020 Last Visit: 02/02/2019 |
| Patient Name | Mr. GOPAL CH. MONDAL | Contact No | |
| Address | 28A CHAKRABORTY LANE | Age | 76 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||