Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 07169 | Date 16/12/2019 |
| Token No | SM/19-20/16330 07/01/2020 | Serial | 038 Last Visit: 07/01/2020 |
| Patient Name | Mr. SHANKAR DEBNATH | Contact No | |
| Address | 25 CHATRA SHITLATALA , BAIDYABATI(M) | Age | 50 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||