Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 03828 | Date 23/02/2019 |
| Token No | SM/18-19/9344 23/02/2019 | Serial | 030 Last Visit: 23/02/2019 |
| Patient Name | Mr. RAKHES DAS | Contact No | 8617269014 |
| Address | CHAREA SHITALA TALA,BAIDYABATI(M) | Age | 30 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||