Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03707 | Date 19/02/2019 |
| Token No | SM/18-19/9060 19/02/2019 | Serial | 090 Last Visit: 15/05/2019 |
| Patient Name | Mr. GOUR CHAKRABORTY | Contact No | 9330460122 |
| Address | CHATRA SHITLATALA BAIDYABATI(M) | Age | 45 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 74 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||