Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05611 | Date 28/06/2019 |
| Token No | SM/19-20/5535 28/06/2019 | Serial | 039 Last Visit: 28/06/2019 |
| Patient Name | Mr. DEBABRATA DAS | Contact No | 9874153126 |
| Address | GAS GODAUN, GHOSH PARA,BAIDYABATI(M) | Age | 39 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||