Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 03527 | Date 12/02/2019 |
| Token No | SM/19-20/5194 24/06/2019 | Serial | 060 Last Visit: 20/09/2019 |
| Patient Name | Mr. SHAIBAL ROY | Contact No | 8478061306 |
| Address | 43/B PRABHAS NAGAR | Age | 30 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 64 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||