Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 07359 | Date 17/01/2020 |
| Token No | SM/19-20/16815 17/01/2020 | Serial | 036 Last Visit: 24/02/2020 |
| Patient Name | Mr. MUKUL SHIL | Contact No | 7980955256 |
| Address | 100/85 VIVEKANANDA SARANI SADGOPE PARA LANE BAIDYABATI(M), 712203 | Age | 63 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 36 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||