Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 01993 | Date 15/11/2018 |
| Token No | SM/19-20/10806 21/09/2019 | Serial | 015 Last Visit: 14/02/2020 |
| Patient Name | Mr. SAMARENDA NATH MONDAL | Contact No | 9339797041 |
| Address | 61A THAKUR DAS BABU LANE | Age | 73 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||