Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 07016 | Date 29/11/2019 |
| Token No | SM/19-20/14307 29/11/2019 | Serial | 076 Last Visit: 29/11/2019 |
| Patient Name | Mr. KRISHANA MALAKAR | Contact No | 9836267739 |
| Address | 16/18 G D BHATTACHARJEE LANE CHATRA , BAIDYABATI(M) | Age | 40 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 38 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||