Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 03753 | Date 21/02/2019 |
| Token No | SM/18-19/9164 21/02/2019 | Serial | 026 Last Visit: 21/02/2019 |
| Patient Name | Mr. LAL MOHAN SHAW | Contact No | 7044340571 |
| Address | CHATRA MANNA PARA , BAIDYABATI(M) | Age | 50 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||