Ticket for Outdoor Patient
| Ward No. 22 | U-PHC No. | Registration No. 04800 | Date 22/04/2019 |
| Token No | SM/19-20/1306 22/04/2019 | Serial | 021 Last Visit: 10/05/2019 |
| Patient Name | Mr. DEBASHISH GHOSHAL | Contact No | 8584905975 |
| Address | 68/3, NARSARY ROAD ,ADARSHO NAGAR, BAIDYABATI(M), | Age | 50 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 43 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||