Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03451 | Date 08/02/2019 |
| Token No | SM/18-19/8279 08/02/2019 | Serial | 005 Last Visit: 08/02/2019 |
| Patient Name | Mr. NABIN CHANDRA DAS | Contact No | 9836973610 |
| Address | 3/A CHATRA GHOSH PARA,2ND LANE | Age | 50 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||