Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00520 | Date 17/08/2018 |
| Token No | SM/19-20/2945 17/05/2019 | Serial | 049 Last Visit: 24/12/2019 |
| Patient Name | Mr. SURENDER NATH DAS | Contact No | 8017931544 |
| Address | 48, CHATRA SACHTASI PARA , BAIDYABATI (M) | Age | 72 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||