Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02800 | Date 03/01/2019 |
| Token No | SM/19-20/4733 17/06/2019 | Serial | 050 Last Visit: 28/08/2019 |
| Patient Name | Mr. SUBANJIT DAS | Contact No | 8013870986 |
| Address | 46, CHATRA LANKAR BAGAN , BAIDYABATI(M) | Age | 21 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 64.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||