Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05291 | Date 29/05/2019 |
| Token No | SM/19-20/3696 29/05/2019 | Serial | 063 Last Visit: 29/05/2019 |
| Patient Name | Mr. UTTAM BHUINYA | Contact No | 9143614983 |
| Address | 81/C VIVEKANANDA SARANI SADGOPE PARA LANE, BAIDYABATI(M) | Age | 60 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | 110/70 mmHg | Weight | 51 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||