Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03690 | Date 19/02/2019 |
| Token No | SM/18-19/9405 25/02/2019 | Serial | 012 Last Visit: 16/03/2019 |
| Patient Name | Mr. CHANDU CH. MONDAL | Contact No | 9038100056 |
| Address | 26 RAMKRISHANA ROAD , BAIDYABATI(M) | Age | 66 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 47 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||