Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06673 | Date 17/10/2019 |
| Token No | SM/19-20/11940 17/10/2019 | Serial | 050 Last Visit: 29/11/2019 |
| Patient Name | Mr. RAHUL SAMANTA | Contact No | 9062558919 |
| Address | BAIDYABATI KAIBURTA PARA ,BAIDYABATI(M) | Age | 25 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 59 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||