Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03225 | Date 29/01/2019 |
| Token No | SM/19-20/10752 20/09/2019 | Serial | 043 Last Visit: 20/09/2019 |
| Patient Name | Mr. UJWAL ROY | Contact No | 7602811943 |
| Address | CHATRA GHOSH PARA , BAIDYABATI(M) | Age | 53 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 44.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||