Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 05106 | Date 14/05/2019 |
| Token No | SM/19-20/2750 14/05/2019 | Serial | 064 Last Visit: 15/05/2019 |
| Patient Name | Mr. SOMNATH MONDAL | Contact No | 8820394411 |
| Address | M C LEHIRI STREET | Age | 35 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||