Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06530 | Date 24/09/2019 |
| Token No | SM/19-20/11471 01/10/2019 | Serial | 089 Last Visit: 01/10/2019 |
| Patient Name | Mr. GOSTHA BIHARI KOLEY | Contact No | |
| Address | 29 JELE PARA LANE,NABAGRAM,BAIDYABATI(M) | Age | 72 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 39 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||