Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05081 | Date 13/05/2019 |
| Token No | SM/19-20/2597 13/05/2019 | Serial | 008 Last Visit: 13/05/2019 |
| Patient Name | Mr. DIBAKAR LAHA | Contact No | 8420785876 |
| Address | 349/1 CHATRA RAMKRISHANA ROAD , BAIDYABATI(M) | Age | 73 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 53 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||