Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03768 | Date 21/02/2019 |
| Token No | SM/18-19/9194 21/02/2019 | Serial | 056 Last Visit: 26/06/2019 |
| Patient Name | Mr. SOMNATH PARUI | Contact No | 9143168993 |
| Address | CHATRA LANKAR BAGAN , BAIDYABATI (M) | Age | 35 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 74 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||