Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 07877 | Date 21/03/2020 |
| Token No | SM/19-20/20060 21/03/2020 | Serial | 016 Last Visit: 21/03/2020 |
| Patient Name | Mr. TARAK MONDAL | Contact No | 9874947086 |
| Address | 2/2 NIL BAGAN LANE , SHEORAPHULI , BAIDYABATI(M) | Age | 40 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | 154/100 mmHg | Weight | 57 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||