Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 05136 | Date 16/05/2019 |
| Token No | SM/19-20/2864 16/05/2019 | Serial | 026 Last Visit: 16/05/2019 |
| Patient Name | Mr. AMIT RAY | Contact No | |
| Address | SHITLATALA JAL TANK, BAIDYABATI(M) | Age | 18 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||