Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06628 | Date 14/10/2019 |
| Token No | SM/19-20/12385 25/10/2019 | Serial | 001 Last Visit: 25/10/2019 |
| Patient Name | Mr. TAPAN KUMAR DUTTA | Contact No | 9007256064 |
| Address | PAHALAMPUR,SHIGUR | Age | 61 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||