Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03097 | Date 19/01/2019 |
| Token No | SM/19-20/13098 13/11/2019 | Serial | 025 Last Visit: 11/11/2020 |
| Patient Name | Mr. SANATAN DAS | Contact No | 9804704162 |
| Address | 58/7(125) SATCHASI PARA LANKAR BAGAN , BAIDYABATI (M) | Age | 72 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 69 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||