Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04916 | Date 26/04/2019 |
| Token No | SM/19-20/3061 21/05/2019 | Serial | 009 Last Visit: 27/05/2019 |
| Patient Name | Mr. ANIL GHOSH | Contact No | 9804877265 |
| Address | 146 J N GUPTA LANE , BAIDYABATI(M) | Age | 52 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 62 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||