Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 04360 | Date 25/03/2019 |
| Token No | SM/19-20/303 05/04/2019 | Serial | 009 Last Visit: 04/05/2019 |
| Patient Name | Mr. AJIT KUMAR DAS | Contact No | 9165608583 |
| Address | CHATRA HARIJAN ROAD , BAIDYABATI(M) | Age | 65 YRS Male |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||