Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 03551 | Date 13/02/2019 |
| Token No | SM/18-19/8588 13/02/2019 | Serial | 055 Last Visit: 13/02/2019 |
| Patient Name | Mr. SUBHANKAR GUIN | Contact No | 9887453208 |
| Address | 53/35/B SHETALA TALA ROAD,BAIDYABATI(M) | Age | 18 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||