Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 08063 | Date 11/04/2020 |
| Token No | SM/19-20/22584 29/05/2020 | Serial | 056 Last Visit: 22/12/2020 |
| Patient Name | Mr. BABUL DAS | Contact No | 7980001933 |
| Address | 4/A,DR,G.C.GOSWAMI STREET | Age | 75 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||