Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 04139 | Date 11/03/2019 |
| Token No | SM/19-20/362 05/04/2019 | Serial | 068 Last Visit: 05/04/2019 |
| Patient Name | Mr. AJAY GHOSH | Contact No | 9874664882 |
| Address | PASCHIM MANNA PARA , BAIDYABATI(M) | Age | 51 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 58 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||