Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04732 | Date 17/04/2019 |
| Token No | SM/19-20/1022 17/04/2019 | Serial | 029 Last Visit: 17/04/2019 |
| Patient Name | Mr. SANDIP MALIK | Contact No | 9903396755 |
| Address | PAHALAM PUR BAIDYABATI(M) | Age | 20 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||