Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 06855 | Date 14/11/2019 |
| Token No | SM/19-20/13181 14/11/2019 | Serial | 008 Last Visit: 14/11/2019 |
| Patient Name | Mr. SUPRIYO MAN | Contact No | 6290404407 |
| Address | 3/2 D.N MUKHERJEE ROAD MALLICKPARA , BAIDYABATI(M) | Age | 17 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||