Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05609 | Date 28/06/2019 |
| Token No | SM/19-20/5521 28/06/2019 | Serial | 025 Last Visit: 28/06/2019 |
| Patient Name | Mr. TAPAN KARAK | Contact No | 9007960741 |
| Address | 127/121 RAMKRISHNA ROAD,BAIDYABATI(M) | Age | 70 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 35 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||