Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 05264 | Date 28/05/2019 |
| Token No | SM/19-20/3575 28/05/2019 | Serial | 016 Last Visit: 26/08/2019 |
| Patient Name | Mr. SAMBHUNATH TEWARI | Contact No | 6291242475 |
| Address | BAURE PARA , BAIDYABATI(M) | Age | 67 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||