Ticket for Outdoor Patient
| Ward No. 8 | U-PHC No. | Registration No. 06706 | Date 21/10/2019 |
| Token No | SM/19-20/12128 21/10/2019 | Serial | 025 Last Visit: 21/10/2019 |
| Patient Name | Mr. AJEET KUMAR RAM | Contact No | 9432322431 |
| Address | 550/32A VIVEKANAND ROAD SONALI PARK, BAIDYABTI(M) | Age | 37 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||