Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03131 | Date 22/01/2019 |
| Token No | SM/19-20/21066 13/04/2020 | Serial | 034 Last Visit: 07/08/2020 |
| Patient Name | Mr. PARIMAL SHEE | Contact No | 9748022877 |
| Address | 51 D/11 BOROBAGAN , | Age | 76 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 63 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||