Ticket for Outdoor Patient
| Ward No. 22 | U-PHC No. | Registration No. 05349 | Date 06/06/2019 |
| Token No | SM/19-20/4096 06/06/2019 | Serial | 072 Last Visit: 06/06/2019 |
| Patient Name | Mr. RAM CHANDARA DAS | Contact No | 8017057792 |
| Address | 11/36,GOSWAMIPARA/1ST LANE | Age | 46 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||