Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05821 | Date 18/07/2019 |
| Token No | SM/19-20/15879 26/12/2019 | Serial | 010 Last Visit: 02/01/2020 |
| Patient Name | Mr. GURUPADA HELDER | Contact No | 8017671290 |
| Address | 185/B VIVEKANANDA SARANI,NABAGRAM,BAIDYABATI(M) | Age | 58 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||