Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 05355 | Date 08/06/2019 |
| Token No | SM/19-20/17031 22/01/2020 | Serial | 012 Last Visit: 22/01/2020 |
| Patient Name | Mr. ANJAN DAS | Contact No | 9339205200 |
| Address | 19 NABIN CHAKRABORTY LANE CHATRA BAIDYABATI(M) | Age | 47 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||