Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04522 | Date 02/04/2019 |
| Token No | SM/19-20/145 02/04/2019 | Serial | 083 Last Visit: 02/04/2019 |
| Patient Name | Mr. HARASIB PAL | Contact No | 8420675933 |
| Address | 16, GOSWAMI PARA LANE,BAIDDYABATI(M) | Age | 73 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 62 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||