Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05594 | Date 27/06/2019 |
| Token No | SM/19-20/5624 29/06/2019 | Serial | 057 Last Visit: 01/08/2019 |
| Patient Name | Mr. SUNIL DAS | Contact No | 8479966569 |
| Address | 26 CHATRA DAS PARA HARIJAN ROAD, BAIDYABATI(M) | Age | 54 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 57 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||