Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03430 | Date 07/02/2019 |
| Token No | SM/18-19/8217 07/02/2019 | Serial | 044 Last Visit: 07/02/2019 |
| Patient Name | Mr. SHAMRUI DAS | Contact No | 8584042989 |
| Address | CHATRA,DAS PARA,BAIDYABATI(M) | Age | 40 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||