Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 02455 | Date 11/12/2018 |
| Token No | SM/19-20/14414 02/12/2019 | Serial | 007 Last Visit: 03/04/2021 |
| Patient Name | Mr. MADAN ROY | Contact No | 7688016516 |
| Address | CHARA BAGAN ,CHATRA,BAIDAYBATI(M) | Age | 67 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 73 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||