Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 05309 | Date 31/05/2019 |
| Token No | SM/19-20/3775 31/05/2019 | Serial | 019 Last Visit: 31/05/2019 |
| Patient Name | Mr. SAMIR DAS | Contact No | 8584998882 |
| Address | 227 CHARA BAGAN BAURE PARA , BAIDYABATI(M) | Age | 60 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 46 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||