Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 05317 | Date 01/06/2019 |
| Token No | SM/19-20/3863 01/06/2019 | Serial | 064 Last Visit: 01/06/2019 |
| Patient Name | Mr. BIMAL BHUIYA | Contact No | |
| Address | 512(333) CHATRA SHITLATALA JAL TANK, BAIDYABTI(M) | Age | 49 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 71.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||