Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 07611 | Date 24/02/2020 |
| Token No | SM/19-20/18543 24/02/2020 | Serial | 019 Last Visit: 24/02/2020 |
| Patient Name | Mr. SAILEN MONDAL | Contact No | 9883517100 |
| Address | PEARAPUR,2 NO SARADA PALLY , PIARAPUR(P) SHEORAPHULI | Age | 50 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||