Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 05556 | Date 25/06/2019 |
| Token No | SM/19-20/23294 22/06/2020 | Serial | 011 Last Visit: 02/07/2020 |
| Patient Name | Mr. ASIT GUCHAIT | Contact No | 7278769134 |
| Address | 68 RAM KRISHANA ROAD, BAIDYABATI(M) | Age | 47 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||