Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03153 | Date 24/01/2019 |
| Token No | SM/19-20/15114 12/12/2019 | Serial | 034 Last Visit: 12/12/2019 |
| Patient Name | Mr. MADHUSUDAN DAS | Contact No | 9239229349 |
| Address | CHATRA LANKAR (SACHTASI PARA ), BAIDYABATI(M) | Age | 55 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||