Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 04904 | Date 25/04/2019 |
| Token No | SM/19-20/1640 25/04/2019 | Serial | 026 Last Visit: 01/08/2019 |
| Patient Name | Mr. KARTIK PAL | Contact No | 9163402755 |
| Address | 146/3 SHITLATALA ROAD BAIDYABATI(M) | Age | 56 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||