Ticket for Outdoor Patient
| Ward No. 23 | U-PHC No. | Registration No. 05608 | Date 28/06/2019 |
| Token No | SM/19-20/5517 28/06/2019 | Serial | 021 Last Visit: 28/06/2019 |
| Patient Name | Mr. ALAUDDEN MALLICK | Contact No | 7449774981 |
| Address | KAJI PARA,BAIDYABATI(M) | Age | 40 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 52 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||