Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 05663 | Date 05/07/2019 |
| Token No | SM/19-20/5865 05/07/2019 | Serial | 028 Last Visit: 10/07/2019 |
| Patient Name | Mr. KASHINATH MONDAL | Contact No | 9804029062 |
| Address | 32/2 KC MUKHERJEE STREET CHATRA SHITLATALA, BAIDYABATI(M) | Age | 65 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 57 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||