Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 05556 | Date 25/06/2019 |
| Token No | SM/19-20/5245 25/06/2019 | Serial | 001 Last Visit: 02/07/2020 |
| Patient Name | Mr. ASIT GUCHAIT | Contact No | 7278769134 |
| Address | 68 RAM KRISHANA ROAD, BAIDYABATI(M) | Age | 47 YRS Male |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | 100/70 mmHg | Weight | 51 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||