Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 07375 | Date 20/01/2020 |
| Token No | SM/19-20/16907 20/01/2020 | Serial | 020 Last Visit: 20/01/2020 |
| Patient Name | Mr. GOPAL TEWARI | Contact No | 7543973209 |
| Address | 268 G.T ROAD , BAIDYABATI(M) | Age | 73 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||