Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 06073 | Date 06/08/2019 |
| Token No | SM/19-20/22751 04/06/2020 | Serial | 036 Last Visit: 05/06/2020 |
| Patient Name | Mr. AMIT KUMAR RAY | Contact No | 9830327646 |
| Address | 61/A THAKURDAS BABU LANE | Age | 54 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||